Normal Waist Circumference Group Research Articles

Predictability of Insulin Resistance Based on the Clinical Manifestations Among Male Medical Students of a Private College in Saudi Arabia.

Background Numerous clinical signs and symptoms are thought to be associatedwith insulin resistance. The purpose of this study was to examine the prevalence of insulin resistance among male medical students attending a private Saudi Arabian institution, based on clinical indications. Methods A convenient non-probability sample consisting of 241 male medical students was used to conduct cross-sectional research.Each participant had an in-person interview as well as anthropometric measurements. The interview consisted of a questionnaire that was used to assess demographic data and clinical manifestations related to insulin resistance. Results The study demonstrated the connection between a few dermatological symptoms and waist circumference as an indicator of insulin resistance. In both the high and normal waist circumference groups, acne was the most common symptom. There was no correlation found between waist circumference and psoriasis, hidradenitis suppurativa, androgenic alopecia, alopecia areata, or vitiligo. Nevertheless, as an indicator of insulin resistance, waist circumference was statistically significantly correlated with both skin tags and acanthosis nigricans. Most students had excessive day sleep, foggy brains, struggled with planning and solving problems, and had a memory that became worse in the past few years. In addition, many students feel hungry even after eating some sweets and usually have extreme thirst. Conclusion Among medical students, skin tags, acanthosis nigricans, and acne were the most prevalent dermatological manifestations. Clinicians need to be aware that skin conditions, sleep difficulties throughout the day, changes in cognition, and food cravings might all be indicators of internal changes and/or illnesses such as diabetes and prediabetes.

Association of Hyper-Triglyceridemic Waist Phenotype and Diabetic Vascular Complication in the Chinese Population.

Diabetic vascular complications are the leading cause of crippling and death of diabetic patients and seriously affect patients' quality of life. It is essential to control the risk factors contributing to vascular complications in patients with Type 2 diabetes (T2DM). This study aimed to examine the association between hyper-triglyceridemic waist phenotype (HWP) and the risk of vascular complication index of diabetes in T2DM patients. The participants with type 2 diabetes mellitus in this study registered at the National Metabolic Management Center (MMC) of Beijing Luhe Hospital from June 2017 to June 2021. Data were collected by trained personnel according to the protocol. The questionnaire containing information on demographic characteristics and lifestyle factors (including alcohol drinking and cigarette smoking et al) was administered by trained interviewers. Logistic regression analysis assessing the associations between the hyper-triglyceridemic waist phenotype and vascular complication index of diabetes. In addition, the subgroup analysis was performed by age, sex, HbA1c, hypertension or not, and education level. After data cleaning, a total of 3221 participants with T2DM were enrolled. The median (IQR) duration of diabetes was 47.00 (3.00, 125.00) months. Compared to the participants in the Normal triglycerides level and Normal waist circumference group (NTNW), those in the Elevated triglycerides level and Enlarged waist circumference group (HTGW) have a higher risk of CKD-related vascular complications; the OR of decreased estimated glomerular filtration rate (GFR) and elevated urinary albumin creatinine ratio (UACR) were 2.21 (95% CI:1.32-3.82) and 2.18 (95% CI:1.69-2.81), respectively. Moreover, compared to the participants in the NTNW group, the ORs of the decreased ankle-brachial index (ABI) and elevated Brachial-ankle pulse wave velocity (baPWV) were 2.24 (95% CI:1.38-3.80) and 1.63 (95% CI:1.28-2.06) in the HTGW group. In summary, there was an association between hyper-triglyceridemic waist phenotype and diabetic vascular complications in the Chinese population.

Association between the lean nonalcoholic fatty liver disease and risk of incident type 2 diabetes in a healthy population of Northwest China: a retrospective cohort study with a 2-year follow-up period.

We aimed to explore the metabolic features of lean nonalcoholic fatty liver disease (Lean-NAFLD) and its association with the risk of incident type 2 diabetes in young and middle-aged people. We conducted a retrospective cohort study of 3001 participants who were enrolled in a health check-up program from January 2018 to December 2020 in the Health Management Center of Karamay People's Hospital. The age, sex, height, weight, body mass index (BMI), blood pressure, waist circumference (WC), fasting plasma glucose (FPG), lipid profiles, serum uric acid and alanine aminotransferase (ALT) of the subjects were collected. The cutoff point of BMI for lean nonalcoholic fatty liver disease is <25 kg/m2. A COX proportional hazard regression model was used to analyze the risk ratio of lean nonalcoholic fatty liver disease to type 2 diabetes mellitus. Lean NAFLD participants had many metabolic abnormalities, such as overweight and obesity with nonalcoholic fatty liver disease. Compared with lean participants without nonalcoholic fatty liver disease, the fully adjusted hazard ratio (HR) for lean participants with nonalcoholic fatty liver disease was 3.83 (95% CI 2.02-7.24, p<0.01). In the normal waist circumference group (man<90cm, woman<80 cm), compared with lean participants without NAFLD, the adjusted hazard ratios (HRs) of incident type 2 diabetes for lean participants with NAFLD and overweight or obese participants with NAFLD were 1.93 (95% CI 0.70-5.35, p>0.05) and 4.20 (95% CI 1.44-12.22, p<0.05), respectively. For excess waist circumference (man≥90 cm, woman ≥80 cm) compared with lean participants without NAFLD, the adjusted hazard ratios (HRs) of incident type 2 diabetes for lean participants with NAFLD and overweight or obese participants with NAFLD were 3.88 (95% CI 1.56-9.66, p<0.05) and 3.30 (95% CI 1.52-7.14, p<0.05), respectively. Abdominal obesity is the strongest risk factor for type 2 diabetes in lean nonalcoholic fatty liver disease.

Preoperative Body Mass Index, Waist Circumference, and Mortality After Major Cancer Surgery: A Nationwide Cohort Study in Korea.

Body mass index (BMI) and waist circumference (WC) were used to evaluate nutritional status and obesity. We aimed to examine whether preoperative BMI or WC was associated with mortality after cancer surgery. This population-based cohort study used data extracted from the National Health Insurance Service database of South Korea. We included adult patients who underwent major cancer surgery with curative intent between January 1, 2016, and December 31, 2020. A total of 87,220 patients were included in the final analysis, and 1,374 (1.6%) died within 90 days after cancer surgery. In the multiple logistic regression model, the BMI < 18.5/kg/m² and > 35 kg/m² groups showed 1.98-fold (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.58-2.49; P < 0.001) and 2.60-fold (OR, 2.60; 95% CI, 1.25-5.40; P < 0.001) higher 90-day mortality after cancer surgery than did the BMI 18.5-24.9 kg/m² group. The 25.0-29.9 kg/m² (P = 0.144) and 30.0-34.9 kg/m² (P = 0.105) BMI groups did not show significant differences compared to the BMI 18.5-24.9 kg/m² group. Compared with the normal WC group, the high (P = 0.052) and very high (P = 0.232) WC groups also did not show significant differences in terms of 90-day mortality. Preoperative BMI < 18.5 kg/m² and > 35 kg/m² is associated with an elevated risk of 90-day mortality after major cancer surgery. However, preoperative WC was not significantly associated with 90-day mortality after cancer surgery.

Prevalence of Cardiovascular Risk Factors in Middle-Aged Lithuanian Men Based on Body Mass Index and Waist Circumference Group Results from the 2006-2016 Lithuanian High Cardiovascular Risk Prevention Program.

Background and aims: This study aimed to estimate the prevalence of cardiovascular risk factors in middle-aged Lithuanian men categorized according to body mass index and waist circumference results. Methods and results: The data were from the Lithuanian High Cardiovascular Risk primary prevention program between 2009 and 2016. This community-based cross-sectional study comprised 38,412 men aged 40 to 54 years old. We compared the prevalence of arterial hypertension, dyslipidaemia, diabetes mellitus, smoking, and metabolic syndrome in body mass index (BMI) and waist circumference (WC) groups. Regarding the allometric anthropometrics for WC, A Body Shape Indices (ABSIs) were analyzed with respect to mortality risk and smoking status. The most prevalent risk factor in men was dyslipidaemia, followed by arterial hypertension and smoking (86.96%, 47.94%, and 40.52%, respectively). All risk factors except for smoking were more prevalent in men with overweight or obesity as measured by BMI compared to men with normal weight. Similarly, smoking was the only cardiovascular risk factor that was more prevalent among subjects with normal WC compared to those with increased WC or abdominal obesity. Elevated ABSI, which is associated with higher mortality risk, was more prevalent in smokers. Conclusion: The most prevalent cardiovascular risk factor among middle-aged Lithuanian men was dyslipidaemia, with a surprisingly high prevalence in all BMI and WC groups. Smoking was the only risk factor most prevalent in subjects with low or normal weight according to BMI. It was also more prevalent in the normal WC group compared to the increased WC or abdominal obesity groups, but ABSI values associated with higher mortality were more prevalent among smokers than non-smokers.

Does Obesity Affect the Outcomes of Clinically Localized Prostate Cancer in the Era of Extraperitoneal Robot-Assisted Radical Prostatectomy?

Purpose: Obesity has been proven to affect the outcomes in open radical prostatectomy. However, the relationship between obesity and the outcomes of robot-assisted radical prostatectomy (RARP) was not conclusive. Herein, we aimed to investigate the impact of obesity on the clinical outcomes after RARP. Materials and Methods: From April 2016 to June 2020, 164 patients underwent RARP by a single experienced surgeon at our institute. Patients with previous transurethral resection of prostate (n = 30), hernioplasty (n = 13), and transperitoneal RARP (n = 26) were excluded. Finally, 105 patients were enrolled and divided into different groups according to their body mass index (BMI) and waist circumference (WC) using the definition of Taiwan National Health Institute. BMI was categorized into three groups (normal: BMI &lt;24, overweight: BMI between 24 and 27, and obese: BMI ≥27 [kg/m2]). WC was categorized into two groups (normal: WC &lt;90 and central obesity: WC ≥90 [cm]). Perioperative outcomes and functional outcomes including preoperative, postoperative erectile function, and postoperative continence status were evaluated. Results: Among BMI groups, 29 patients were normal, 43 patients were overweight, and 33 patients were obese. Console time and sum time showed a significant difference in different BMI groups (P = 0.034 and 0.016, respectively). Of the 101 patients with available magnetic resonance imaging, 74 patients' WC were normal, and 27 patients were central obese. Blood loss in central obesity group was significant more than normal WC group (300 ml vs. 200 ml, P = 0.04). No significant differences were observed in pathological and functional outcomes in both groups. Conclusion: Obesity and central obesity seemed to result in longer operation time and more blood loss in extraperitoneal RARP while functional outcomes can be maintained regardless of the obesity degree. Large-scale studies are necessary to further explore the relationship between obesity and the outcomes of RARP in future.

Relationship between waist circumference and cardiorespiratory fitness in Chinese children and adolescents: Results from a cross-sectional survey

BackgroundThis article assessed the relationship between waist circumference (WC) and cardiorespiratory fitness (CRF) of children and adolescents aged 7–18 years. MethodsUsing a stratified cluster random sampling method, 92,574 children and adolescents (47,364 males and 45,210 females) were extracted. CRF was measured by performance in the 20 m shuttle run test (20mSRT) and the subsequent estimation of maximal oxygen consumption (V˙O2max) using the Léger equations. Participants were divided into five groups of WC percentiles and three groups of CRF percentiles by the Lambda Mu Sigma (LMS). The correlation between WC and CRF was examined by one-way ANOVA and curvilinear regression analysis. ResultsWC increased with age, while V˙O2max showed an age-related decline. Controlling for gender, urban, and rural factors, for children and adolescents aged 10–12, 13–15, and 16–18 years, the V˙O2max Z-score of the normal WC group was significantly higher than the very low WC group (P < 0.05). Controlling for gender, urban, and rural factors, for participants aged 7–18 years, the V˙O2max Z-score of the normal WC group was significantly higher than the high WC group and the very high WC group (P < 0.05). ConclusionsIt generally shows a “parabolic” trend between WC-Z and V˙O2max-Z. The CRF among children and adolescents in the normal WC group is significantly higher than that in the low and the high WC groups.

Association Between Obesity and Cardiovascular Disease in Elderly Patients With Diabetes: A Retrospective Cohort Study.

Some studies have suggested that patients with type 2 diabetes mellitus (T2DM) concomitant with obesity have better clinical outcomes than normal-weight patients with T2DM. We evaluated associations among obesity, cardiovascular disease (CVD) events, and mortality in elderly patients with T2DM without CVD. This retrospective observational study from 2009 to 2017, with a mean follow-up of 7.26 years, included 249 903 elderly (≥ 65 years) patients with T2DM and no preexisting CVD from the Korean National Health Information Database. We categorized subjects according to body mass index (BMI) and waist circumference (WC) and analyzed a composite of stroke, myocardial infarction, and all-cause death using Cox proportional hazards regression analysis, adjusting for baseline covariates. The incidence rate of composite primary outcomes was 30.95/1000 person-years. The primary outcome risk had an L-shaped and a U-shaped association with BMI and WC, respectively. In the multivariable Cox proportional hazard models, the risk of primary composite outcomes in the highest BMI group (≥ 30 kg/m2; hazard ratio [HR] = 0.824; 95% CI, 0.794-0.855) was lower than in the normal BMI group (≥ 18.5 and < 23 kg/m2). Conversely, that in the highest WC group (≥ 100 cm/≥ 95 cm; men/women; HR = 1.434; 95% CI, 1.384-1.486) was higher than in the normal WC group (< 90 cm/< 85 cm; men/women). Our study with elderly patients with diabetes results suggest that while BMI is an inadequate risk indicator for outcomes related to obesity, WC is a suitable alternative.

Change in waist circumference over 2 years and the odds of left ventricular hypertrophy among Chinese children

Background and aimsHigh waist circumference (WC) is associated with left ventricular mass index (LVMI) in childhood. However, no studies have assessed the association between WC change and left ventricular hypertrophy (LVH) in childhood. This study aimed to investigate the association between change in WC status over 2 years on LVH among Chinese children. Methods and resultsData were from a population-based prospective cohort study in China. Children without LVH at baseline (n = 1067) were assigned to four WC status change groups (persistent normal WC, WC loss, WC gain, and persistent abdominal obesity). Over a 2-year follow-up, 103 (out of 1067) children had LVH. LVMI levels were the highest among the persistent abdominal obesity group (31.5 ± 3.8 g/m 2.7), lower in the WC gain group (31.0 ± 3.6 g/m 2.7) and the WC loss group (29.8 ± 3.7 g/m 2.7), and lowest in the persistent normal WC group (29.1 ± 3.7 g/m 2.7). Compared with children in the persistent normal WC group, the odds of LVH was highest in the persistent abdominal obesity group [odds ratio (OR) = 3.57, 95% confidence interval (CI): 2.18–5.83], followed by the WC gain group (OR = 2.85, 95% CI: 1.50–5.41). In contrast, the odds of LVH was not increased in the WC loss group (OR = 0.93, 95% CI: 0.21–4.07). ConclusionAlthough these findings highlight the importance of maintaining normal WC in childhood to reduce the odds of developing LVH, our data suggest the increased odds associated with abdominal obesity can be reversed by WC loss.

Association of changes in waist circumference with cardiovascular disease and all-cause mortality among the elderly Chinese population: a retrospective cohort study.

BACKGROUNDTo examine the association of baseline waist circumference (WC) and changes in WC with cardiovascular disease (CVD) and all-cause mortality among elderly people.METHODSA total of 30,041 eligible participants were included from a retrospective cohort in China. The same questionnaire, anthropometric and laboratory measurements were performed at baseline (2010) and the first follow-up (2013). The percent change in WC between baseline and the first follow-up was calculated to evaluate three years change of WC. We collected the occurrence of CVD and all-cause death from the first follow-up to December 31, 2018. Restricted cubic splines and Cox proportional-hazards regression models were used to evaluate the relationship between baseline WC/ changes in WC and mortality.RESULTSThe dose-response relationships between baseline WC and CVD mortality were U- or J-shaped. In low WC group, compared with stable group, the fully adjusted hazard ratio (aHR) for CVD mortality was 1.60 (95% CI: 1.24−2.06) in WC gain group among men. In normal WC group, the CVD mortality risk increased with WC gain (men: aHR = 1.86, 95% CI: 1.36−2.56; women: aHR = 1.83, 95% CI: 1.29−2.58). In moderate-high WC group, the CVD mortality risk increased with WC gain (men: aHR = 1.76, 95% CI: 1.08−2.88; women: aHR = 1.46, 95% CI: 1.04−2.05) and risk decreased with WC loss (men: aHR = 0.54, 95% CI: 0.30−0.98; women: aHR = 0.59, 95% CI: 0.37−0.96).CONCLUSIONSFor the elderly population, WC gain may increase CVD mortality risk regardless of baseline WC, whereas WC reduction could decrease the risk only in the moderate-high WC group.

Proteinuria Pasien Diabetes Melitus dan Obesitas Poli Penyakit Dalam RS Ibnu Sina Makassar

Background: The prevalence of diabetes mellitus in the world has increased which is certainly accompanied by a rapid increase in the incidence of its chronic complications like kidney disorders. Insulin resistance, the patophysiology of diabetes mellitus, also associated with obesity, which both are the main risk factors for cardiovascular events. Obesity also known as a risk factor for kidney disease that proved by the presence of proteinuria in obesity patients. Objective: To determine the correlation of obesity with occurrence of proteinuria in patients with type 2 DM in internal medicine polyclinic Ibnu Sina Hospital Makassar. Method: A cross sectional study on 32 type 2 DM patients at Ibnu Sina Hospital as measured by body weight, height and waist circumference. Urinalysis examination is also performed at that time. Results: In this study, there were 4 patients (12,5%) patients with proteinuria (+), 1 patient (3.1%) with proteinuria (++), 2 patients (6.3%) with proteinuria (+++) and 1 patient (3.1%) with proteinuria (++++). According to BMI, we found that 17 patients (53.1%) were overweight, 5 patients (15.6%) were class 1 obesity, no class 2 obesity patient, and 1 patients (3.1%) were class 3 obesity. In Waist circumference examination we found that in normal waist circumference group there is 1 patient that did not has proteinuria while in the abnormal waist circumference group, 8 patients out of 31 patients have proteinuria. After doing statistical analysis to assess the correlation of obesity with proteinuria obtained p value&gt; 0.05. Similarly, the correlation analysis waist circumference with proteinuria obtained p value&gt; 0.05. Conclusion: There is no correlation between obesity and proteinuria as well as waist circumference and proteinuria correlation in type 2 DM patients.

The Impact of Abdominal Obesity on Cardiopulmonary Fitness in Chinese Heart Failure Patients

Introduction There is an inverse relationship between abdominal obesity measured by waist circumference (WC) and cardiopulmonary fitness (peak oxygen consumption, VO2peak) among healthy white people. However, knowledge of Chinese heart failure patients remains scant because heart failure patients generally experience significant impaired cardiopulmonary fitness, and Asian populations tend to have more abdominal fat compared to white populations. Hypothesis Abdominal obesity based on Asian WC cut-off points results in significant changes in VO2peak and the WC can negatively impact the VO2peak in Chinese heart failure patients. Methods This is a cross-sessional study. Data was collected from 72 heart failure patients with NYHA classI∼IV (80% II) with mean ejection fraction of 46.5%. VO2peak was measured during a symptom-limited bicycle exercise test; and WC was measured between the lower rib and the iliac crest. Abdominal obesity was defined by the recommended Asian cut-off points (90 cm for men, 85 cm for women). Other clinical variables were collected from electronic medical records. Non-parametric tests, Spearman's correlation coefficients, and a linear regression model were used with p-value Results Among 72 patients, mean age was 65.4 (range: 36∼91); 80.6% were male; and mean BMI was 24.4 kg/m2 with 45 (63%) classified as abdominally obese. Overall, significant lower VO2peak value was found in the abdominal obesity group including men and women (-2.6 mL/kg/min, 95%CI: -4.5, -0.8) than in the normal WC group. When patients were stratified into two gender groups and three age groups (young: Conclusion Recommended Asian WC thresholds for abdominal obesity are a useful instrument for detecting clinically, statistically relevant decreases in VO2peak among Chinese heart failure patients. For male patients or those under 60, WC was inversely associated with their VO2peak. For each 5∼6cm increase in WC, reducing VO2peak showed a clinically significant decrease of 1 mL/kg/min among Chinese heart failure patients. Further research with larger samples sizes is needed to support WC as a cardiopulmonary fitness self-management tool.

Correlation Between Waist Circumferences With Obstructive Sleep Apnea Risk in Ent Clinic Sanglah Hospital Denpasar

Pauses in breathing during sleep or better known as obstructive sleep apnea (OSA) is one of the disorders that greatly disturb the quality of life of many people. Lifestyle changes such as reducing obesity can reduce OSA. One of the method to measure the level of obesity is the measurement of waist circumference, as one good indicator to know the risk of obstructive sleep apnea (OSA). Therefore, in this study would like to understand the relationship between waist circumferences with obstructive sleep apnea (OSA). This research method is analytical research with cross sectional study approach. The sample of this study was 385 visitors who came to the ENT clinic Sanglah Hospital Denpasar. The risk data for Obstructive Sleep Apnea (OSA) was taken using a research questionnaire adapted from the Berlin questionnaire and waist circumference measurements. Processing and data analyzing were done using the help of a computer program. The result of prevalence of abnormal waist circumference was 49 people (37,4%) lower than normal waist circumference group in high-risk category that was 82 people (62,6%). Based on the result of chi-square test, there was a significant relationship between increased waist circumference and risk of suffering Obstructive Sleep Apnea (OSA) (p = 0.000) (p &lt;0.05). There is a correlation between increased waist circumference and risk of suffering from Obstructive Sleep Apnea (OSA). Therefore it is advisable to keep the weight remains ideal by setting a healthy lifestyle.

Study on correlation of obesity with short-term prognosis in acute myocardial infarction

BackgroundObese patients with established coronary artery disease have reduced mortality compared to normal or low body mass index (BMI) patients. The reason for the relation is not yet clearly understood. We sought to evaluate the association of BMI and waist circumference (WC) at the time of presentation in patients with myocardial infarction (MI) with one-year adverse cardiac events. MethodsIn this prospective cohort study, we included consecutive patients with acute MI admitted to a tertiary care hospital during a period of one year. Upon admission, BMI and WC were measured. Patients were followed-up for a period of one year and the primary composite outcome of death or non-fatal MI was correlated with BMI and WC categories. ResultsThere were 703 patients (males 559 (79.5%)). Combined non-fatal MI and death at one year was 128 (18.2%). Incidence of primary outcome was 25.0% in low BMI group, 19.9% in normal BMI group, 13.1% in overweight group, 13.4% in class I obese, and 11.1% in class II obese groups. In univariate analysis, the inverse correlation was significant (p value=0.007). In one-year follow-up period, 12.8% in high and 20.8% in normal WC groups had primary outcome (p value=0.01). Both BMI and WC lost their predictive value in multivariate analysis. ConclusionsLow BMI and normal WC were associated with a worse short-term outcome in patients with acute MI. Neither BMI nor WC independently predicted cardiac events or death after acute MI.

25-hydroxyvitamin D, Igf-1, And Waist Circumference A Cross-sectional Study

PURPOSE: Waist circumference has been shown to have a link to various forms of chronic disease and low levels of Vitamin D (25(OH)D) and IGF-1. The purpose of this study is to assess if there is a relationship with either Vitamin D (25(OH)D) or IGF-1 levels and waist circumference. METHODS: Participants were males and females (n=26), ages 25-65. Participants reported to the UNLV Nutrition Center to give informed consent and underwent a finger stick blood draw under sterile conditions as well as resting blood pressure and waist circumference measurements. The sample was used to determine serum 25(OH)D and IGF-1 levels using ELISA kits. Participants completed food frequency questionnaires about eating habits prior to study and questionnaires were administered to determine level and type of physical activity. Data were collected and evaluated using Microsoft Excel and SPSS software. Correlation regression was analyzed for significance (P= 0.05) RESULTS: Subjects were separated into two groups according to waist circumference (Female >35”, Male >40”). Although no significant difference was found between large waist and normal waist circumference groups, an inverse relationship between IGF-1 and waist circumference was noted for the combined groups (R2 = 0.841, P= 0.006) A significant relationship between 25(OH)D and waist circumference did not exist (R2 = 0.9709, P= 0.649). CONCLUSIONS: Waist circumference has an inverse relationship to IGF-1. Abdominal obesity may cause a reduction in the amount of free IGF-1 produced by the body which could increase risk for chronic disease. Obtaining waist circumference as well as activity level is relatively convenient in medical treatment settings and could provide clinicians with valuable information regarding patient’s level of risk for chronic disease.

Left Ventricular Mass in Children and Adolescents With Elevated Body Mass Index and Normal Waist Circumference

Children and adolescents with elevated body mass index (BMI) who have normal waist circumference (NWC) have a cardiometabolic risk profile similar to normal children. However, there is a lack of adequate information regarding their left ventricular mass (LVM). The present study was undertaken to evaluate LVM in children with elevated BMI with NWC. LVM was assessed by echocardiography in 247 children (age 2 to 19 years) without evidence of heart disease. Data on those who had elevated BMI with NWC (group 1, n = 80) were compared with matched normal controls with normal BMI who had NWC (group 2, n = 80) and children with elevated BMI with increased waist circumference (IWC; group 3, n = 87). Correlations, t tests, and linear regressions were used for statistical testing. LVM in children with elevated BMI with NWC was not significantly different from normal controls (97.6 ± 44.4 vs 100.7 ± 47.9 g, p = 0.6713, respectively); however, it was significantly less than that in subjects with elevated BMI who also had IWC (97.6 ± 44.4 vs 114.5 ± 47.8 g, p = 0.0193, respectively). Similar to normal controls, those subjects with elevated BMI with NWC had a stronger correlation between LVM and lean body mass (R(2) = 0.86 and 0.86, respectively) than subjects with elevated BMI with IWC (R(2) = 0.75). In conclusion, children with elevated BMI with NWC appear to have a similar LVM profile as children with normal BMI with NWC. The present study emphasizes the importance of measuring waist circumference in children with elevated BMI.

Blood pressure among children and adolescents with normal weight but large waist circumference in Shandong, China

The present study examined the blood pressure (BP) characteristics of normal weight children and adolescents with a large waist circumference (WC) in a large population in Shandong, China. A total of 38,826 students (19,460 boys and 19,366 girls) aged 7-17 years participated in this study. Height, weight, WC, and BP of all subjects were measured. Normal weight was defined by the international cutoffs of body mass index; central obesity was defined as WC ≥ 90th percentile; relatively high BP status was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for age and gender. And 5.06 and 8.19 % of the normal weight boys and girls had central obesity. The Z-scores of SBP, DBP and the prevalence of relatively high BP for both boys and girls were all significantly higher in the normal weight with central obesity groups than in the normal weight with normal WC groups. These observations highlight that normal weight children and adolescents with central obesity might have an increased risk of elevated BP.

ASSA13-14-6 Effect of Different Body Mass Index and Waist Circumference on Arterial Elasticity in Essential Hypertension

<h3>Objective</h3> To investigate the effect of different body mass index (BMI) and waist circumference on arterial elasticity in essential hypertension. <h3>Methods</h3> The basic information was collected in a total of 776 essential hypertensive patients. According to BMI and waist circumference level, all patients were divided into four groups, namely, normal BMI and normal waist circumference group (Igroup, <i>n</i> = 194 cases), normal BMI and elevated waist circumference group (IIgroup, <i>n</i> = 195 cases), excessive BMI and normal waist circumference group (III group, <i>n</i> = 196 cases), excessive BMI and elevated waist circumference group (IVgroup, <i>n</i> = 191 cases). Brachial ankle pulse wave velocity (baPWV) and ankle-brachial blood pressure index (ABI) were observed in all patients. Arterial stiffness index (AI) was calculated using the blood lipid of all hypertension patients. <h3>Results</h3> baPWV (2120 ± 263) and AI (3.35 ± 0.87) in IV group were significantly higher than Igroup (<i>P</i> &lt; 0.01), IIgroup and III group (<i>P</i> &lt; 0.05). ABI (0.72 ± 0.15) in IV group were significantly lower than Igroup (<i>P</i> &lt; 0.01), IIgroup and III group (<i>P</i> &lt; 0.05). There were no statistical differences between IIgroup and III group in ABI and AI (<i>P</i> &gt; 0.05). Results of 2 × 2 factorial analysis showed that there was a distinctive and synergistic effect between excessive BMI and elevated waist circumference on arterial stiffness. <h3>Conclusions</h3> Arterial elasticity function was aggravated damaged in essential hypertension in patients with abdominal obesity. Excessive BMI and elevated waist circumference had interaction and synergistic effect on the damage of arterial elasticity function.

Obesity Phenotype and Coronary Heart Disease Risk as Estimated by the Framingham Risk Score

There are conflicting data as to whether general or abdominal obesity is a better predictor of cardiovascular risk. This cross-sectional study involved 4,573 subjects aged 30 to 74 yr who participated in the Fourth Korea National Health and Nutrition Examination Survey conducted in 2008. Obesity phenotype was classified by means of body mass index (BMI) and waist circumference (WC), and participants were categorized into 4 groups. Individuals' 10-yr risk of coronary heart diseases (CHD) was determined from the Framingham risk score. Subjects with obese WC had a higher proportion of high risk for CHD compared to the normal WC group, irrespective of BMI level. Relative to subjects with normal BMI/normal WC, the adjusted odds ratios (ORs) of normal BMI/obese WC group (OR 2.93 [1.70, 5.04] and OR 3.10 [1.49, 6.46]) for CHD risk in male were higher than obese BMI/obese WC group (OR 1.91 [1.40, 2.61] and OR 1.70 [1.16, 2.47]), whereas the adjusted ORs of obese BMI/obese WC group (OR 1.94 [1.24, 3.04] and OR 3.92 [1.75, 8.78]) were higher than the others in female. Subjects with obese BMI/normal WC were not significantly associated with 10-yr CHD risk in men (P = 0.449 and P = 0.067) and women (P = 0.702 and P = 0.658). WC is associated with increased CHD risk regardless of the level of BMI. Men with normal BMI and obese WC tend to be associated with CHD risk than those with obese BMI and obese WC.

Waist Circumference, Body Mass Index, and Survival in Systolic Heart Failure: The Obesity Paradox Revisited

Background Higher body mass index (BMI) is associated with improved heart failure (HF) survival, but the role of waist circumference (WC) in HF outcomes has not been studied. Methods and Results A total of 344 patients with advanced systolic HF had WC and BMI measured at presentation. High WC was defined as ≥88 cm in women and ≥102 cm in men, and high BMI as ≥25 kg/m 2. Two-year urgent heart transplant (UT)–free survival in high vs normal WC groups was 77.9% vs 64.3% ( P = .025) and in high vs normal BMI was 89.8% vs 58.2% ( P < .001). After multivariable adjustment, normal WC compared with high WC was associated with higher all-cause mortality (risk ratio [RR] 2.76, 95% confidence interval [CI] 1.34–5.71) and higher risk of death/UT (RR 2.14, 95% CI 1.25–3.68). The best outcomes were seen in those with both high WC and high BMI. Conclusions High WC, an alternative anthropometric index of obesity more specific to abdominal adiposity, high BMI, and the combination of high WC/high BMI were each associated with improved outcomes in this advanced HF cohort, lending further support for an obesity paradox in HF. The role of body composition in HF survival should be a focus of future investigation.