Normal Waist Research Articles

Association between hypertriglyceridemic-waist phenotype and cardiovascular disease: A cohort study and meta-analysis.

BackgroundThe association between hypertriglyceridemic-waist (HTGW) phenotype and cardiovascular disease (CVD) remains inconsistent and debatable. We aimed to prospectively investigate the relationship between HTGW phenotype and CVD.Methods and resultsWe included 8,216 participants from the China Health and Retirement Longitudinal Study. Participants were categorized into four subgroups: NTNW: normal triglyceride levels and normal waist circumference; HTNW: high triglyceride levels and normal waist circumference; NTGW: normal triglyceride levels with enlarged waist circumference; HTGW: high triglyceride levels and enlarged waist circumference. A Cox proportional hazards model was applied to determine the association between HTGW phenotype and CVD. A meta-analysis was conducted to incorporate the results of the current study and the previous-related studies on the association of HTGW phenotype and CVD. In the present cohort study, compared to the NTNW phenotype, those with NTGW (Hazard ratios (HRs) 1.34, 95% confidence intervals (CIs) 1.16–1.55) and HTGW (HRs 1.37, 95% CIs 1.16–1.62) phenotype were significantly associated with CVD risk. The meta-analysis further confirmed the significant association between HTGW phenotype and CVD [the pooled relative risk for HTGW vs. NTNW was 1.39 (1.29–1.49)].ConclusionThe HTGW phenotype was associated with the increased risk of CVD, independently of established risk factors. A simple assessment of HTGW phenotypes might help to identify individuals with a high risk of developing CVD.

Obesity Indexes Are Positively Correlated With Blood Pressure Variability in Patients With Essential Hypertension

Abstract Background To analyze the relationship between obesity indexes, types of obesity, and blood pressure (BP) variability (BPV) in patients with hypertension. Methods A total of 284 patients (147 males, 137 females) with essential hypertension (EH) aged 70.7 ± 14.2 years were enrolled. Patients were grouped by body mass index (BMI), waist circumference, and obesity types. According to BMI, patients were divided control (BMI 18.5 to <24.0), overweight (BMI 24.0 to <28.0), and obesity (BMI ≥28.0 kg/m2) groups. According to waist circumference, patients were divided into control (<90 for male and <85 cm for female) and the obesity (≥90 for male and ≥85 cm for female) groups. According to obesity type, patients were divided into control (normal BMI and waist circumference), simple abdominal obesity (normal BMI and increased waist circumference), simple overweight (BMI ≥24.0 and normal waist circumference), and combined obesity (BMI ≥24.0 kg/m2 and increased waist circumference) groups. Twenty-four-hour ambulatory BP was recorded. Results When divided by BMI, daytime systolic BP standard deviation (dSBPSD), nighttime diastolic BP standard deviation (nDBPSD), daytime systolic BP variation coefficient (dSBPCV), and nighttime systolic BP standard deviation (nSBPSD) were higher in obesity group compared with control and overweight groups (P < 0.05). When divided by waist circumference, dSBPSD, daytime diastolic BP standard deviation (dDBPSD), and dSBPCV in the abdominal obesity group were higher than the control group (all P < 0.05). When divided by obesity type, simple abdominal obesity, simple overweight obesity, and combined obesity groups had higher 24-hour diastolic BP (24hDBP) and nighttime diastolic BP (nDBP) than the control group (P < 0.05), and the combined obesity group had higher daytime systolic BP (dSBP) and dSBPSD (P < 0.05). BMI was positively correlated with dSBPSD, nSBPSD, and nDBPSD (r = 0.160, 0.136, 0.163). Body fat percentage (BF%) was positively correlated with nSBPSD, nDBPSD, and nighttime systolic BP coefficient of variation (nSBPCV) (r = 0.175, 0.128, 0.153). Waist circumference was positively correlated with dSBPSD (r = 0.138, P < 0.05). Multiple linear regression analysis showed that dSBPSD was positively correlated with BMI, waist circumference, and waist-to-hip ratio, while nSBPSD, nDBPSD were positively correlated with BMI and BF% (P < 0.05), and nSBPCV was positively correlated with BF% (P < 0.05). Conclusions Obesity indexes are positively correlated with BPV in EH patients.

Cutoff values of body fat composition to predict metabolic risk factors with normal waist circumference in Asian Indian population.

The aim of the study is to see if visceral fat volume (VFV), subcutaneous fat volume (SFV), and visceral-subcutaneous fat ratio (VSR) can be used to detect metabolically obese normal weight individuals in Asian Indian population. This is a single center prospective cross-sectional study and 80 cases having either hypertension, diabetes, or hyperlipidemia with normal waist circumference and 80 controls having normal metabolic parameters with normal waist circumference were evaluated. Visceral and subcutaneous fat volumes and visceral to subcutaneous fat ratios were determined by computed tomography (CT) at L4-L5 level with a slice thickness of 5 mm. Visceral fat volume, subcutaneous fat volume, and VSR are significantly higher in patients with metabolic risk factors as compared to those without risk factors. Volume of subcutaneous fat is significantly higher in females as compared to males. VSR is higher in males in our study. The cutoff values for VFV, SFV, and VSR to predict at least one metabolic syndrome are 8.5 cm3, 15.7 cm3, and 0.61 in males and 7.0 cm3, 16.5 cm3, and 0.44 in females. For individuals with normal waist circumference, VFV, SFV, and VSR can effectively predict the presence of one metabolic risk factor. • Visceral fat volume, subcutaneous fat volume, and visceral-subcutaneous fat ratio can predict individuals at risk of metabolic syndrome having normal waist circumference. • Higher VSR in Indian population is due to low reservoir of primary adipose tissue fat compartment which leads to diversion of adipocytes into the secondary adipose tissue fat compartment. • This data can be used as a screening tool in preventive radiology for identifying individuals at risk of developing metabolic syndrome.

Firmicutes, Bacteroidetes and Actinobacteria in Human Milk and Maternal Adiposity.

The main objective was to explore the relationship between the microbiota of human milk and adiposity in Mexican mothers during the first lactation stage. Methods: Seventy lactating women were included. Adiposity by anthropometric measurements and by bioelectric impedance was obtained. The donation of human milk was requested, from which bacterial DNA was extracted and qPCR of the 16S region was performed. The Mann–Whitney U test, Spearman and Pearson correlations, and multiple linear regressions models were also calculated. Results: The median percentage of Bacteroidetes had a direct and significant correlation with normal adiposity, current BMI, waist circumference, and body fat percentage. The correlation with current BMI became significantly inverse in women with BMI ≥ 25. In women with normal BMI, the percentage of Actinobacteria showed a direct and significant correlation with current BMI, waist circumference, and percentage of body fat. Multiple linear regressions showed that pre-pregnancy BMI was the variable with the highest predictive value with the Bacteroidetes phyla in normal BMI and in BMI ≥ 25. Conclusions: the adiposity of the woman before pregnancy and during lactation would have an important effect on the abundance of Bacteroidetes and Actinobacteria in human milk.

Combined Effects of Obesity and Dyslipidaemia on the Prevalence of Diabetes Amongst Adults Aged ≥45 Years: Evidence from a Nationally Representative Cross-Sectional Study.

Objectives: This study aimed to explore the combined effects of different types of obesity and dyslipidaemia on the prevalence of diabetes in middle-aged and elderly residents. Methods: Data were obtained from the 2015 China Health and Retirement Longitudinal Studydatabase, and 5023 valid participants were included after excluding those with missing data. A Chi-square test was used to test the difference in the prevalence of diabetes between the groups. Binary logistic regression was used to analyse the relationship between different types of obesity combined with dyslipidaemia and the prevalence of diabetes. Results: Multivariate logistic regression analysis showed that, compared with those with a body mass index <24/ortholiposis, the subgroup with systemic obesity/dyslipidaemia had 4.37 times the risk of diabetes (OR = 4.37, 95% CI = 2.36–8.10, p < 0.001). In addition, compared with those with a normal waist circumference (WC)/ortholiposis, the subgroup with abdominal obesity/dyslipidaemia had 3.58 times the risk of diabetes (OR = 3.58, 95% CI = 2.49–5.13, p < 0.001). Conclusions: The coexistence of obesity and dyslipidaemia can significantly increase the risk of diabetes, suggesting that the strict control of weight, WC and lipid level is beneficial to the prevention of diabetes.

Short‐term weight loss decreased the risk of chronic kidney disease in men with incident nonalcoholic fatty liver disease

The study aimed to examine the association of obesity and chronic kidney disease (CKD) after nonalcoholic fatty liver disease (NAFLD) occurrence. The study enrolled 10,311 adult men with newly diagnosed NAFLD and without CKD in the Kailuan cohort (2006-2013). The Fine-Gray model was used to compare advanced CKD risk in NAFLD with different baseline or trajectories in obesity measures. During a median follow-up of 10 years, maintaining normal waist circumference or waist-hip ratio, or transition from obesity to nonobesity determined by BMI, decreased 31% (hazard ratio [HR]=0.69; 95% CI: 0.51-0.93), 34% (HR=0.66; 95% CI: 0.45-0.95), and 38% (HR=0.62; 95% CI: 0.40-0.96) of the CKD hazard compared with the "constantly without obesity" subgroup, respectively. NAFLD patients with at least 10% weight loss (HR=0.58; 95% CI: 0.34-0.97) and with 7.0% to 9.9% weight loss (HR=0.53; 95% CI: 0.28-0.99) had a lower risk for CKD than those with weight change ±4.9%. Compared with the stable weight population, the lower risk of ≥7% weight loss was observed only in patients with elevated blood pressure (adjusted HR=0.48; 95% CI: 0.28-0.81). Short-term weight loss of at least 7% could decrease CKD risk, especially among patients with obesity and elevated blood pressure. It is important to monitor waist circumference, waist-hip ratio, and weight for NAFLD management.

Preconception period in women and men undergoing Assisted Reproduction: A gender approach for reproductive health

ObjectiveTo evaluate lifestyle and risk factors playing a role in increasing the burden of cardiovascular diseases and to increase attention of clinicians who should envision a broader preconception approach in ART, not only in women but also in men. Study designIn this cross-sectional study we investigated 90 Caucasian couples, referred to the Internal Medicine Clinic at the Assisted Reproductive Technology Centre, in order to better define in preconceptional period their cardiovascular risk profile, based on metabolic parameters and lifestyle behaviours. ResultsWe observed two-fold increase of overweight in men in comparison to women (p = 0.006). Values of waist ≥ 94 cm in men and ≥ 80 cm in women were present in 53.3% of men and 32.2% of women (p = 0.007). Similarly, values of WHR according to gender cut-off, were present in 64.4% of men and in 32.2% of women (p < 0.0001). In men we observed a significantly higher prevalence of hypertension (p = 0.02), significantly lower HDL-c (p = 0.001) and higher levels of total cholesterol (p = 0.01), LDL-c and triglycerides (p = 0.001). Sedentary behaviour was observed in about 60% of both genders. Alcohol consumption was reported by 42.2% of men and 26.7% of women (p = 0.04) and smokers were more prevalent among women (26.7%) than men (24.4%). We observed a lower adherence to Mediterranean Diet related to consumption of red meat and meat products (p = 0.02), as well as of legumes consumption (p = 0.01) in men, whereas sweet/pastries (p = 0.05) and fruits (p = 0.06) in women. Men and women with normal BMI, waist and WHR, showed a higher Mediterranean diet adherence in comparison to overweight/obese study population(p < 0.001). Finally, higher education level predicted the higher Mediterranean diet adherence in both gender (p = 0.01 for men, p = 0.03 for women). ConclusionsThis study paid attention on preconceptional health in couples planning ART. Women have a greater biological role in childbearing, whereas the role of men is underestimated. The need to conceive through ART offers a window of opportunity not only to evaluate cardiovascular profile and lifestyle factors in couples prior to conception, but also to manage comorbidities and promote health behaviours in order to improve fertility and health outcomes in both women and men at short and long-term.

Association between hypertriglyceridemic-waist phenotype and non-alcoholic fatty liver disease: a general population-based study

BackgroundHypertriglyceridemic-waist (HTGW) phenotype has been proposed as a practical tool for screening the risk of cardiovascular diseases and glycemic metabolic disease. This study sought to investigate the relationship between HTGW phenotype and non-alcoholic fatty liver disease (NAFLD).MethodsA total of 14,251 subjects who took part in health screening were enrolled in the study and NAFLD was diagnosed by abdominal ultrasound. According to triglyceride (TG) and waist circumference, the study population was divided into four phenotypes, in which HTGW phenotype was defined as TG ≥ 1.7 mmol/L and male waist circumference ≥ 90 cm or female waist circumference ≥ 80 cm. Multivariate logistic regression analysis was used to evaluate the relationship between HTGW phenotype and NAFLD.ResultsIn the current study, 2.43% of the subjects had HTGW phenotype, while the prevalence of NAFLD in subjects with HTGW phenotype was 77.81%. After full adjustment for covariates, compared with people with normal waist circumference and TG levels, the risk of NAFLD in people with normal TG levels but enlarged waist circumference increased by 39% [OR:1.39, 95%CI: 1.15, 1.68], in people with normal waist circumference but elevated TG levels increased by 96% [OR:1.96, 95%CI: 1.65, 2.33], and in subjects with HTGW phenotype increased by 160% [OR:2.60, 95%CI: 1.88, 3.58]. Additionally, further analysis suggested that there were significant interactions between age, height, BMI and NAFLD risk associated with TGW phenotypes. Receiver operating characteristic curves analysis suggested that the combination of TG and waist circumference further improved the diagnostic value for NAFLD.ConclusionsHTGW phenotype is associated with NAFLD risk in the general population, which may be a novel and accessible indicator for NAFLD screening.

The Association Between Hypertriglyceridemic-Waist Phenotype and Chronic Kidney Disease in Patients with Type 2 Diabetes: A Cross-Sectional METAL Study.

BackgroundThe aim of this study was measuring the association between the hypertriglyceridemic-waist (HTGW) phenotype and chronic kidney disease in a large type 2 diabetes population.MethodsA total of 4254 diabetic patients from the cross-sectional Environmental Pollutant Exposure and Metabolic Diseases in Shanghai (METAL) study were enrolled. The hypertriglyceridemic-waist (HTGW) phenotype was defined as the presence of an elevated waist circumference (WC) and elevated triglyceride (TG) concentration. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2 or urinary albumin creatinine ratio (uACR) more than 30 mg/g. Linear and multiple logistic regression models were used for measuring the association between HTGW phenotype and chronic kidney disease.ResultsThe prevalence of CKD was 29% and 35.8% in total participants and participants with HTGW phenotype, respectively. Subjects in the HTGW phenotype group were more likely to have CKD (OR 1.47, 95% CI: 1.11, 1.95) compared with subjects in the normal waist circumference and normal triglycerides (NTNW) group. HTGW phenotype was both associated with the increasing risk of decreased eGFR (OR 1.31, 95% CI: 1.02, 1.75) and elevated uACR (OR 1.57, 95% CI: 1.18, 2.11). Furthermore, the stratified analysis showed that the strongest positive association between HTGW phenotype and CKD presence was found in the subgroup of presence of hypertension. The associations were all fully adjusted for age, sex, BMI, current smoking, current drinking and other confounding factors.ConclusionOur study suggested a positive association between the HTGW phenotype and CKD in Chinese type 2 diabetes patients. Further prospective studies are needed to confirm our findings and to investigate the underlying biological mechanisms.

Serum Fetuin-A and Risk of Gestational Diabetes Mellitus: An Observational Study and Mendelian Randomization Analysis.

Fetuin-A was reported to be associated with risk of type 2 diabetes, but its association with incident gestational diabetes mellitus (GDM) was less studied. We aimed to examine the association between fetuin-A levels in early pregnancy and risk of incident GDM and to evaluate whether this association was causal. A total of 332 pregnant women with GDM and 664 matched controls were included in this nested case-control study. Multivariable conditional logistic regression was applied to investigate the prospective association between serum fetuin-A in early pregnancy and subsequent risk of GDM. Two-sample Mendelian randomization (MR) analysis was used to examine the causal association, using summary statistics from the CHARGE Consortium and the FinnGen consortium. The mean age of the participants was 28.0 years, and the mean gestational age was 11.0 weeks (range 6-15) at enrollment. In the final model, the odds ratio (OR) for GDM comparing the extreme quartiles of fetuin-A levels was 1.78 (95% CI 1.06, 2.98; P for trend = 0.009), and the restricted cubic spline analysis indicated a linear association (P for nonlinearity = 0.83). This positive association was found in women with waist circumference <80 cm but not in those with waist circumference ≥80 cm (P for interaction = 0.04). However, MR analyses showed no evidence of a causal association with an OR of 0.91 (95% CI 0.67, 1.23) per unit increment of fetuin-A. Serum fetuin-A levels in early pregnancy were positively associated with risk of GDM, particularly in those with normal waist circumference. However, we found no genetic evidence for a causal association.

Metabolic syndrome and risk of stroke incidence in a rural community in Japan

Objective To investigate the relationship between metabolic syndrome (MetS) and stroke incidence in a rural population by a prospective cohort study over 18.6 years.Methods From 1996 to 1998, 4,068 subjects (aged 40-74 years) underwent a health checkup in O city, Ehime Prefecture, Japan, and 3,969 subjects were included, excluding those with a history of stroke, to determine whether they had suffered a stroke or died from stroke by the end of December 2018. The subjects were stratified into six groups on the presence of high waist circumference at baseline and the number of risk factors (0, 1, or 2 or more) for high blood pressure, dyslipidemia, and high blood glucose, according to the diagnostic criteria for MetS in Japan. Kaplan-Meier analysis of MetS survival curves and Cox proportional hazards models were used to calculate sex- and age-adjusted hazard ratios and population attributable fractions (PAFs) for total stroke, hemorrhagic stroke, and cerebral infarction.Results During the follow-up period, 376 patients were identified as having had a stroke; the percentage of MetS in the stroke group was 15.2% compared to 9.4% in the non-stroke group, a significant difference. The sex- and age-adjusted hazard ratios for total stroke and cerebral infarction were approximately 2-fold higher in the groups with 1 risk and 2 or more risks, regardless of waist circumference, than in the group with normal waist circumference and no risks. PAF to total stroke incidence was highest in the group with normal waist circumference and 1 risk factor (18.9%).Conclusions The contribution of MetS to stroke incidence was not significant. Consistent with previous findings, the risk of stroke was increased in non-obese individuals who had at least one risk factor, such as high blood pressure.

Hypertension modifies the associations of body mass index and waist circumference with all-cause mortality among older Chinese: a retrospective cohort study

BackgroundThe effect of baseline hypertension status on the BMI–mortality association is still unclear. We aimed to explore the relationships of body mass index (BMI) and waist circumference (WC) with all-cause mortality among older hypertensive and normotensive Chinese individuals.MethodsThis retrospective cohort study was conducted in Xinzheng, Henan Province, Central China. The data came from the residents’ electronic health records of the Xinzheng Hospital Information System. A total of 77,295 participants (41,357 hypertensive participants and 35,938 normotensive participants) aged ≥ 60 years were included from January 2011 to November 2019. Cox proportional hazard regression model was used to examine the relationships.ResultsDuring a mean follow-up of 5.3 years, 10,755 deaths were identified (6,377 in hypertensive participants and 4,378 in normotensive participants). In adjusted models, compared with a BMI of 18.5–24 kg/m2, the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of BMI < 18.5, 24–28 and ≥ 28 kg/m2 for mortality in hypertensive participants were 1.074 (0.927–1.244), 0.881 (0.834–0.931) and 0.856 (0.790–0.929), respectively, and 1.444 (1.267–1.646), 0.884 (0.822–0.949) and 0.912 (0.792–1.051), respectively, in normotensive participants. Compared with normal waist circumference, the adjusted HRs and 95% CIs of central obesity for mortality were 0.880 (0.832–0.931) in hypertensive participants and 0.918 (0.846–0.996) in normotensive participants. A sensitivity analysis showed similar associations for both hypertensive and normotensive participants.ConclusionLow BMI and WC were associated with a higher risk of all-cause mortality regardless of hypertension status in older Chinese individuals. The lowest risk of death associated with BMI was in the overweight group in normotensive participants and in the obesity group in hypertensive participants.

Skeletal muscle mass and abdominal obesity are independent predictors of hepatic steatosis and interact to predict ten-year cardiovascular disease incidence: Data from the ATTICA cohort study

Sarcopenia and sarcopenic obesity may be associated with nonalcoholic fatty liver disease (NAFLD). This study examined the association between low skeletal muscle mass, with or without central obesity, with NAFLD, as well as their interaction on predicting 10-year incidence of cardiovascular disease (CVD).This was a post-hoc analysis of the ATTICA study. At baseline, 3042 participants from the Attica region of Greece were recruited; 2020 completed the 10-year follow-up visit for CVD. NAFLD was assessed through hepatic steatosis index (HSI). Skeletal muscle mass index (SMI) was calculated to assess skeletal muscle mass. SMI was studied in tertiles, stratified by sex; the first tertile corresponds to the lowest SMI, the second to middle, and the third to highest SMI. Abnormal waist circumference was defined as ≥102 cm for men and ≥88 cm for women. The combined 10-year endpoint was the development of a fatal or nonfatal CVD event. Logistic regression analysis was used to assess the association between NAFLD prevalence and SMI as well as Cox regression analysis to assess the interaction of both variables on the incidence of CVD over 10 years.Higher rates of NAFLD were observed in the first (45%) compared to the second [33%; odds ratio (OR): 0.50, 95% confidence interval (95%CI): 0.41-0.61] and the third (22%; OR: 0.24, 95%CI: 0.19-0.29) SMI tertile. This association remained robust after multiple adjustments; significance was marginally lost, when waist circumference was added to the model. When SMI and waist circumference were evaluated jointly, participants with moderate/high SMI and normal waist circumference had the lowest and those with low SMI and abnormal waist circumference the highest NAFLD rate (24.3 and 60.5%, respectively; P < 0.001). Ten-year CVD incidence was gradually lower from the first (22.8%) to second (16.1%) and third SMI tertile (8.2%) (P < 0.001). The hazard ratio (HR) for the third vs. the first SMI tertile for predicting CVD in fully adjusted model was 0.69 (95%CI: 0.46, 1.00). The unadjusted HR for NAFLD predicting CVD was 3.00 (95%CI: 2.28-3.95). Finally, there was a significant interaction among NAFLD, SMI and waist circumference (P = 0.04) in determining the 10-year CVD incidence; the association between NAFLD and 10-year CVD remained significant for the participants with low SMI and normal or abnormal waist circumference, but not those with moderate/high SMI and normal or abnormal waist circumference.Increasing SMI and lower abdominal obesity are independently associated with lower rates of NAFLD, and the two interact as key determinants of NAFLD. Low SMI and central obesity are independent predictors of CVD and were shown to interact with NAFLD in determining 10-year CVD risk.

The Association between Urinary Malondialdehyde and Obesity

Background: Malondialdehyde (MDA) is end-product of polyunsaturated fatty acid. Studies have highlighted MDA as a biomarker of whole-body oxidative stress. Objective: To explore the association between urinary MDA and obesity status. Materials and Methods: The present research was performed as a cross-sectional study at the Primary Care Unit of a tertiary care university hospital in southern Thailand. Data were collected via questionnaire, medical records, and urinary MDA sample measured with high-performance liquid chromatography. Data were analyzed by R program version 4.0.0. Results: One hundred fifteen participants comprised of 57 obese and 58 non-obese patients were included in the present study. The means of body mass indexes (BMIs) were 27.5±2.3 versus 21.9±1.7 kg/m² in obese and non-obese group, respectively. The median of urinary MDA among obese was significantly higher than in non-obese participants at 5.7 (6.0) versus 3.6 (3.9) μg/mL, (p=0.016). Additionally, the urinary MDA in central obesity at 5.8 (5.9) μg/mL was higher than normal waist circumference at 3.5 (3.8) μg/mL, (p=0.009). Conclusion: Urinary MDA was significantly higher in the obesity and central obesity group than the lower or normal BMI and waist circumference group. Obesity could be an essential factor promoting the body’s oxidative stress. Since oxidative stress is well known to be involved in the causes of lifestyle-related or chronic diseases, this specific biomarker can be used to detect and monitor the development of these diseases. Keywords: Biomarker; Malondialdehyde; Obesity; Oxidative stress; Urinary MDA

Abstract EP41: Relationship Between Body Mass Index And Low Total Bilirubin In US Adults

Background: Low total bilirubin (TBili) is associated with increased cardiovascular risk, in part mediated by adipose tissue-related hormones. determined whether excess adiposity (measured by BMI) is associated with low TBili levels. Methods: Our study population consisted of 14,129 (6,902 male and 7,227 non-pregnant female) adults aged ≥20 years from the 1999-2018 National Health and Nutrition Examination Surveys. Participants with elevated liver enzymes (AST&gt;80 or ALT &gt;112 IU/L; AST/ALT &gt;5), excessive alcohol consumption (&gt;20 drinks/week for males; &gt;10 for females), iron overload (transferrin &gt;50%), anemia (hemoglobin&lt;12 g/dl if female; &lt;13 g/dl if male), elevated TBili (≥1.2 mg/dl), low albumin (&lt;3.5 g/dl), or positive hepatitis B/C serology were excluded. We categorized measured BMI into 7 categories (&lt;18.5, 18.5-22.9, 23.0-24.9, 25.0-27.4, 27.5-29.9, 30-34.9, ≥35). Low TBili, our primary outcome, was defined as &lt;0.4 mg/dl for both males and females. We used sex-stratified multivariable logistic regression, sequentially adjusting for demographics, cardiometabolic factors, and liver function. Results: Among 14,129 adults (mean age [SD] of 47 [15] years, 51% female, 69% White), nearly 32% had BMI ≥30. Both males and females with BMI ≥30 had &gt;50% odds of low TBili compared to a BMI of 23-24.9, even after adjustment for covariates (Table). There was no significant association between overweight range BMIs and low TBili. Adjustment for serum albumin most significantly attenuated the associations between obese-range BMIs and low TBili, especially in males. Further classifying each BMI category into high and normal waist circumference (WC;&lt;88cm for female, &lt;102cm for male) groups revealed that high WC individuals, even with BMI of 23-24.9, had increased odds of low TBili (OR [95% CI]: 2.35 [1.40, 3.94]). Conclusions: Obese BMI is associated with higher likelihood of low TBili. Longitudinal studies are needed to determine directionality of association and risk of downstream cardiovascular disease.

The association between hypertriglyceridemic-waist phenotype and chronic kidney disease: a cohort study and meta-analysis

Evidence on the association between hypertriglyceridemic-waist phenotype (HTGW) and chronic kidney disease (CKD) is limited and inconsistent. We aimed to explore such association among 7406 Chinese aged ≥ 45 years in a cohort setting, followed by a meta-analysis. Participants were categorized into four phenotypes: NTNW (normal triglycerides and normal waist circumference), NTGW (isolated enlarged waist circumference), HTNW (isolated high triglycerides), and HTGW (high triglycerides and enlarged waist circumference). We used multivariate logistic regression to determine the association between different phenotypes and risk of CKD in the cohort study. For meta-analysis, we searched relevant studies from Embase, Medline, PubMed, and Web of Science from dataset inception up to May 1, 2021. A random-effect model was used to estimate the pooled effect and I2 statistic was applied to evaluate heterogeneity. In the cohort study, compared to the NTNW phenotype, HTGW (OR 1.82, 95% CI 1.32 to 2.51, p < 0.01) and NTGW (OR 1.48, 95% CI 1.13 to 1.94, p = 0.004) were significantly associated with CKD risk after 4 years follow-up, but not for the HTNW phenotype. The meta-analysis also showed a positive association between HTGW phenotype and CKD risk (pooled OR 1.53, 95% CI 1.31 to 1.79, I2 = 62.4%). Assessment of triglyceridemic-waist phenotypes might help to identify individuals with high-risk of developing CKD.

The association of hypertriglyceridemic waist phenotype with hypertension: A cross-sectional study in a Chinese middle aged-old population.

The present study aimed to evaluate the relationship between the hypertriglyceridemic waist (HTGW) phenotype and hypertension. We undertook a cross‐sectional study with a sample of 9015 adults from China. The HTGW phenotype was defined as elevated waist circumference (WC) and elevated triglyceride (TG) concentration. Logistic regression analysis was used to evaluate the association between the HTGW phenotype and hypertension. The prevalence of hypertension was significantly higher in individuals with the HTGW phenotype, than in those with the normal waist normal triglyceride (NWNT) phenotype (89.9% vs 75.3%, respectively, P < .001). After adjusting for age, sex, BMI, current smoker, and current alcohol consumption, the HTGW phenotype was associated with hypertension (Odds Ratio (OR)1.53; 95% CI 1.25–1.87). After further adjustment for potential confounders, the HTGW phenotype was still significantly associated with hypertension (adjusted OR1.28; 95% CI 1.04‐1.58) regardless of sex. The subgroup analyses generally revealed similar associations across all subgroups. This study indicated that the HTGW phenotype was strongly associated with hypertension, and blood pressure should be clinically monitored in individuals with the HTGW phenotype. We suggested a combined use of hypertriglyceridemia waist phenotype in identifying participants who are at high risk of hypertension.

Когнітивні функції у пацієнтів з фібриляцією передсердь та абдомінальним ожирінням

З метою визначення та порівняння частоти й тяжкості когнітивних розладів (КР) у пацієнтів молодого й середнього віку з фібриляцією передсердь (ФП), абдомінальним ожирінням (АО) та метаболічним синдромом (МС) обстежено 196 пацієнтів. КР, що характеризувалися зниженням пам’яті, уваги, порушеннями сприйняття, вербальної швидкості й виконавчих функцій, діагностовано у 88,3 % пацієнтів з ФП і АО та у 89,5 % пацієнтів з МС. У пацієнтів з ФП, у тому числі в поєднанні з АО, додементні й тяжкі КР зустрічалися частіше, ніж у хворих з АО і синусовим ритмом. В обстежених із синусовим ритмом і нормальною окружністю талії без серцево-судинних захворювань тяжкі й помірні КР не спостерігалися. Ступінь вираженості КР у пацієнтів з ФП і АО не залежав від структурних змін сонних артерій і серця. Факторами ризику розвитку КР у пацієнтів молодого й середнього віку з ФП і АО були наявність МС та підвищений рівень С-реактивного протеїну в сироватці крові. Пацієнтам молодого й середнього віку з ФП, АО і МС необхідно оцінювати когнітивні функції для ранньої діагностики та запобігання прогресуванню КР.

Meta-analysis of the Effect of Excess Waist Circumference on Hypertension Incidence in Adolescents

Background: Hypertension is a condition characterized by blood pressure measurements showing a systolic pressure of &gt;130 mmHg and a diastolic pressure of &gt;80 mmHg. There are so many cases of hypertension in adolescents that begin with being overweight or obese. One way to determine a person's level of obesity is by measuring the waist-to-hip ratio. This study was aimed to analyze the effect of excess waist circumference on the incidence of hypertension in adolescents. Subjects and Method: This study is a meta-analysis study with the following PICO, population: adolescents. Intervention: excess waist circumference. Comparison: normal waist circumference. Outcome: hypertension. This study uses PRISMA flowchart guidelines. The article search process was carried out between 2011-2021 using online databases, namely PubMed, Google Scholar, and Science Direct. Based on the database, there were 9 articles that met the inclusion criteria. The analysis was carried out using RevMan 5.3 software. Results: There are 9 cross-sectional studies originating from 2 continents, namely America and Asia. Based on the data showed that adolescents with excess waist circumference increased the risk of hypertension 1.59 times compared to adolescents with normal waist circumference (aOR= 1.59; 95% CI= 1.00 to 2.52; p= 0.050). Conclusion: Excess waist circumference increases the risk of hypertension in adolescents. Keywords: hypertension, waist circumference, teens Correspondence: Ulul Azmi Zuhaira. Politeknik Kesehatan Kemenkes Malang. Jl. Besar Ijen No. 77 C, Oro-oro Dowo, Kec. Klojen, Kota Malang, Jawa Timur. Email: ululazmizuhaira@gmail.com. Mobile: +62822-4501-2258.

Sex differences in cardiometabolic abnormalities in a middle-aged Maltese population.

There are sex differences in distribution of fat and in the prevalence of overweight and obesity. We therefore sought to explore sex differences in the prevalence of adiposity-metabolic health phenotypes, in anthropometric and cardio-metabolic parameters, and in the relationship between body mass index (BMI) categories and metabolic health. We conducted a cross-sectional study carried out between January 2018 and June 2019, of a nationally representative sample of the Maltese Caucasian population aged 41 ± 5years. Metabolic health was defined as presence of ≤ 1 parameter of the metabolic syndrome as defined by the National Cholesterol Education Program-Adult Treatment Panel III criteria. Males exhibited the unhealthy metabolic phenotype more frequently than women (41.3% vs 27.8%). In total, 10.3% of normal weight men and 6.3% of normal weight women were metabolically unhealthy. Males had a higher median BMI, but a lower proportion of males exhibited an abnormally high waist circumference as compared with females. A significant difference in sex distribution was noted for each body composition phenotype. In a contemporary sample of middle-aged individuals, males were more metabolically unhealthy and more insulin resistant than their female counterparts in spite of exhibiting an abnormal waist circumference less frequently and having similar waist index. This suggests that the currently used cut-offs for normal waist circumference should be revised downwards in men. Since even normal weight men were more often metabolically unhealthy than normal weight women, BMI cut-offs may also need to be lowered in men.