Normal-weight Central Obesity Research Articles

Relationship of normal weight central obesity on comorbid diseases: Systematic Review

Relationship of normal weight central obesity on comorbid diseases: Systematic Review

Normal Weight Central Obesity is a Poor Prognostic Factor for Sudden Sensorineural Hearing Loss.

To investigate the role of normal weight central obesity (NWCO) in the prognosis of sudden sensorineural hearing loss (SSNHL). We retrospectively investigated 807 cases of SSNHL from January of 2008 to August of 2019 from the Department of Otorhinolaryngology at Kaohsiung Medical University Hospital in southern Taiwan. We analyzed the association between overweight and obesity, NWCO, and the prognosis of SSNHL. The demographic and clinical characteristics, audiometry results, and outcomes were also reviewed. The nonobese (body mass index [BMI] < 24 kg/m2) and overweight and obese groups (BMI ≥ 24 kg/m2) comprised 343 (42.50%) and 464 (57.50%) patients, respectively. The favorable prognosis rates in the nonobese and the overweight and obese groups were 45.48% and 45.91%, respectively, without a significant difference (P = .9048). Multivariate logistic regression revealed that BMI (adjusted odds ratio [aOR] = 1.00, 95% CI = 0.948-1.062, P = .9165) was not significantly associated with SSNHL recovery. The normal weight noncentral obesity (NWNCO) and NWCO groups comprised 266 (77.55%) and 77 (22.45%) patients, respectively, and had favorable prognosis rates of 48.50% and 35.06%, respectively. The difference between the groups was significant (P = .0371). Multivariate logistic regression analysis revealed that NWCO (aOR = 2.51, 95% CI = 1.292-5.019, P = .0075) was significantly associated with SSNHL recovery. NWCO may significantly affect the prognosis of SSNHL.

Normal Weight Obesity and Normal Weight Central Obesity is Associated with Geriatric Syndromes in Hospitalized Older Adults

Normal Weight Obesity and Normal Weight Central Obesity is Associated with Geriatric Syndromes in Hospitalized Older Adults

Relationship between normal weight central obesity and arterial stiffness in Chinese adults with hypertension

Background and aimsNormal weight central obesity (NWCO) is a category of obesity that is characterized by having a normal BMI and presence of abdominal obesity. Recently, studies have reported that NWCO was associated with the cardiovascular diseases. The researches exploring the relationship between NWCO and arterial stiffness are limited. So this study intended to investigate the relationship between NWCO and arterial stiffness in Chinese adults with hypertension. Methods and resultsThis study is a sub-study of the China H-type Hypertension Registry Study. We included 8580 Chinese hypertensive patients with normal weight (18.5 kg/m2 ≤BMI <24 kg/m2). Central obesity was defined as waist-height ratio ≥0.5, and participants were categorized into two groups: NWCO and normal weight and no central obesity (NWNO). Using the brachial-ankle pulse wave conduction velocity (baPWV) assessed the arterial stiffness. Multiple linear regression analysis was used to evaluate relationship between NWCO and baPWV. Multiple logistic regression analysis was used to evaluate relationship between NWCO and arterial stiffness. Of 8580 participants, 4327 (50.4 %) were NWCO. The multiple linear regression analysis demonstrated that people with NWCO had higher baPWV value (total people: β = 38.33, 95%CI 22.82–53.84; men: β = 39.87, 95%CI 18.43–61.32; women: β = 29.65, 95%CI 7.20–52.09) compared with NWNO. The baPWV ≥1800 cm/s was defined as arterial stiffness, and the multiple logistic regression analysis showed that people with NWCO associated higher arterial stiffness risk (total people: OR = 1.25, 95%CI 1.12–1.39; men: OR = 1.29, 95%CI 1.11–1.50; women: OR = 1.18, 95%CI 1.01–1.38). ConclusionNWCO is significantly related to increased risk of arterial stiffness in Chinese adults with hypertension.

Hypertension in Individuals with Normal-Weight Obesity and Normal-Weight Central Obesity: A Study on Sunni Muslims of Uttar Pradesh, North India

In practice, individuals who are found normal through various adiposity indicators are screened out from the risk of obesity and subsequently from other cardiometabolic syndromes like hypertension. Against this backdrop, this study aims to examine the prevalence of hypertension among individuals having normal-weight obesity (NWO) and normal-weight central obesity (NWCO). In the present study, Cross-sectional data of 214 participants (100 males and 114 females) were collected using purposive sampling. Adiposity indices like body mass index (BMI), percent body fat (PBF), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) were calculated. Individuals were then categorized into NWO and NWCO. Systolic (SBP) and diastolic (DBP) blood pressure were also measured. All the data were analyzed using SPSS software. The prevalence of generalized obesity measured through BMI and PBF were 15% and 69.6% respectively. Central obesity measured through WC, WHR, and WHtR was 33.6%, 60.3%, and 11.2%, respectively. The prevalence of NWO in the total population was 21.9%. On the other hand, the prevalence of NWCO was 3.3%, 21.5%, and 12.1% as per WC, WHR, and WHtR respectively. The mean value of SBP and DBP was higher in individuals with NWO and NWCO. Preventive, interventional, and community-specific studies on NWO, NWCO, and their association with hypertension should be taken up by researchers who will help our policymakers in managing hypertension.

Normal-weight central obesity: implications for diabetes mellitus.

Current guidelines for obesity prevention and control focus on body mass index (BMI) and rarely address central obesity. Few studies have been conducted on the association between normal-weight central obesity and the risk of diabetes mellitus (DM). 26,825 participants from the National Health and Nutrition Examination Survey (NHANES) were included in our study. A weighted multivariate logistic regression model was used to analyze the relationship between different obesity patterns and the risk of DM. Our results suggest that normal-weight central obesity is associated with an increased risk of DM (OR: 2.37, 95% CI: 1.75-3.23) compared with normal-weight participants without central obesity. When stratified by sex, men with normal-weight central obesity, obesity and central obesity were found to have a similar risk of DM (OR: 3.83, 95% CI: 2.10-5.97; OR: 4.20, 95% CI: 3.48-5.08, respectively) and a higher risk than all other types of obesity, including men who were overweight with no central obesity (OR: 1.21, 95% CI: 0.96-1.51) and obese with no central obesity (OR: 0.53, 95% CI: 0.30-0.91). Our results highlight the need for more attention in people with central obesity, even if they have a normal BMI.

Normal-weight central obesity and risk of cardiovascular and microvascular events in adults with prediabetes or diabetes: Chinese and Britishcohorts.

To investigate the relationship between body fat distribution and risk of cardiometabolic and microvascular events among individuals with prediabetes or diabetes with normal body mass index (BMI). A total of 17,232 participants with prediabetes or diabetes from UK Biobank (UKB) with 12-year follow-up and 499 diabetic participants from China with 2-year follow-up with normal BMI were included. Anthropometric measurements of waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), and body fat composition assessment of trunk-to-leg fat ratio (TLFR) were obtained. Outcomes included incident all-cause and cardiovascular mortality and macrovascular and microvascular diseases. In British cohort, participants with central obesity defined by WHR had 27%-54% higher risk of incident all-cause mortality (hazard ratio (HR)1.42, 95% confidence interval (CI): 1.23-1.64), cardiovascular mortality (HR1.54 [1.15-2.07]), myocardial infarction (HR=1.43 [1.15, 1.78]), stroke (HR 1.26 [0.90, 1.75]), heart failure (HR=1.27 [1.00, 1.61]), diabetic nephropathy (HR1.33 [1.07, 1.65]), and diabetic retinopathy (DR) (HR=1.48 [1.12, 1.96]) than those without obesity. Central obesity defined by WC and WHtR was associated with 40%-44% and 23%-98% higher risks of developing diabetic events, respectively. In the Chinese cohort, individuals with abdominal obesity, defined by WC (HR1.44) or WHtR (HR1.43) but not by WHR, carried more than 40% higher risk of developing DR than those without it. Higher TLFR carried 1.30-2.85 times higher risk of CVD and microvascular diseases among the dysglycemic population. Body fat distribution diseases among individuals with prediabetes or diabetes are associated with an increased risk of cardiometabolic and microvascular diseases independent of BMI.

Normal weight central obesity and hypertension in India: Cross-sectional finding from LASI, 2017-19

Background and aimThe current public health guidelines for preventing and managing obesity still emphasize the importance of maintaining a normal Body Mass Index, while paying little attention to central obesity, which is common among the general population. Normal Weight Central Obesity (NWCO) is a less explored risk factor for hypertension in India. Therefore, this study aims to investigate the prevalence of NWCO and its association with hypertension in India. Methods and resultsThe cross-sectional study used data from the Longitudinal Aging Study in India (LASI), 2017–19, which included 54,016 participants (22,438 men and 31,578 women). Hypertension was evaluated following the JNC-VIII guidelines for the detection, evaluation, and treatment of hypertension. Anthropometric measurements were taken to identify NWCO. The study found that NWCO was more prevalent among women (33.9%) than men (17.8%), while men had a higher prevalence of hypertension (47.6%) than women (43.8%). In India, the state of Haryana had the highest proportion of NWCO among men (26.4%), while Kerala had the highest proportion among women (39.1%). Binary logistic regression analysis showed that NWCO was significantly associated with an increased risk of hypertension. The odds ratio (aOR) was 1.57 (95% CI 1.45–1.67, p < 0.001) in men and 1.53 (95% CI 1.43–1.63, p < 0.001) in women, compared to normal-weight study participants. ConclusionsThe study emphasizes the importance of considering central obesity in individuals with a normal BMI when assessing cardiovascular risk, particularly for hypertension. State-specific data can help identify high-risk areas and facilitate targeted prevention and treatment strategies.

Underweight and Normal Weight Central Obesity Among Filipinos and its Association with Cardiovascular Risks and Diseases

In most epidemiological studies underweight and normal weight central obesity groups are either underrepresented, excluded, or merged to the normal weight category. This study aims to compare underweight and normal weight central obesity groups and possible age and gender differences in association with cardiovascular risk and diseases using a previous local study. Methods: Participants were Filipinos aged 20 years or older who had participated in and completed the desired data in the National Nutrition and Health Survey 2008. Participants were categorised into two groups: underweight and normal weight central obesity. The profiles of the groups were compared and their association with cardiovascular risks and diseases determined, using adjustment models for age and sex. Results: A total of 3,009 participants were included in this study: 684 (22.7%) underweight and 2,325 (77.3%) normal weight central obesity. The mean age for underweight participants was 47.8 years versus 43.2 years for normal weight central obesity; 56.6% of the participants were female and 43.4% were male. In comparison to normal weight central obesity using adjustment models for age and sex, ORs were as follows: hypertension OR 1.49, diabetes OR 1.71, and dyslipidaemia OR 1.8. Using a sex stratified model there were significant differences in diastolic blood pressure (mean, male 78 versus female 75), triglycerides (mean, male 117 versus female 106), HDL level (mean, male 40.3 versus female 41.6) and LDL level (mean, male 99 versus female 115). Using an age stratified model, coronary artery disease ORs were 25th percentile (OR 2), 50th percentile (OR 2.4) and 75th percentile (OR 1.9); cerebrovascular accident 75th percentile (OR 2.5) and peripheral artery disease 50th percentile (OR 3.4). Hypertension 25th percentile (OR 2.0), 50th percentile (OR 2.4) and 75th percentile (OR 1.9); diabetes 25th percentile (OR 6.7), 75th percentile (OR 1.7) and dyslipidaemia 25th percentile (OR 1.2) were significantly higher in the underweight group. Conclusion: Greater association in hypertension and coronary artery disease in all age groups, stroke among the older age group, and diabetes among the younger and older age groups were seen among underweight participants compared to normal weight central obesity among Filipinos.

Association of normal-weight central obesity with hypertension: a cross-sectional study from the China health and nutrition survey

BackgroundCentral obesity is associated with an increased risk of hypertension in the general population. However, little is known regarding the potential relationship between central obesity and the risk of hypertension among adults with a normal body mass index (BMI). Our aim was to assess the risk of hypertension among individuals with normal weight central obesity (NWCO) in a large Chinese population.MethodsWe identified 10 719 individuals aged 18 years or older from the China Health and Nutrition Survey 2015. Hypertension was defined by blood pressure measurements, physician diagnosis, or the use of antihypertensive treatment. Multivariable logistic regression was used to assess the association of obesity patterns, defined by BMI, waist circumference (WC) and waist hip ratio (WHR), with hypertension after adjusting for confounding factors.ResultsThe patients’ mean age was 53.6 ± 14.5 years, and 54.2% were women. Compared with individuals with a normal BMI but no central obesity, subjects with NWCO had a greater risk of hypertension (WC: OR, 1.49, 95% CI 1.14–1.95; WHR: OR, 1.33, 95% CI 1.08–1.65). Overweight-obese subjects with central obesity demonstrated the highest risk of hypertension after adjustment for potential confounders (WC: OR, 3.01, 95% CI 2.59–3.49; WHR: OR, 3.08, CI 2.6–3.65). Subgroup analyses showed that the combination of BMI with WC had similar findings to the overall population except for female and nonsmoking persons; when BMI was combined with WHR, a significant association of NWCO with hypertension was observed only in younger persons and nondrinkers.ConclusionsCentral obesity, as defined by WC or WHR, is associated with an increased risk of hypertension in Chinese adults with normal BMI, highlighting the need to combine measures in obesity-related risk assessment.

Association of intraabdominal fat with the risk of incident chronic kidney disease according to body mass index among Korean adults.

The association between abdominal visceral adipose tissue and the risk of incident chronic kidney disease according to body mass index in the Asian population, remains unclear. We evaluated the impact of abdominal adiposity stratified by body mass index on the risk of incident chronic kidney disease. A cohort study included 11,050 adult participants who underwent health check-ups and re-evaluated the follow-up medical examination at a single university-affiliated healthcare center. Cross-sectional abdominal adipose tissue areas were measured using computed tomography. The primary outcome was progression to chronic kidney disease (estimated glomerular filtration rate <60 ml/min/1.73m2). The highest quartile of visceral adipose tissue was used for the cut-off of central obesity. During the mean of 5.6 follow-up years, 104 incident chronic kidney disease cases were identified. The risk for chronic kidney disease incidence was significantly increased in the 3rd and 4th quartile ranges of visceral adipose tissue [hazard ratio (95% confidence interval)]: 4.59 (1.48-14.30) and 7.50 (2.33-24.20), respectively. In the analysis stratified by body mass index, the chronic kidney disease incidence risk was increased in the highest quartile range of visceral adipose tissue in the normal weight group: 7.06 (1.35-37.04). However, there was no significant relationship between visceral adipose tissue and chronic kidney disease in the obese group. Compared to the subjects with normal weight and absent central obesity, the hazard ratio for chronic kidney disease incidence was 2.32 (1.26-4.27) among subjects with normal weight and central obesity and 1.81 (1.03-3.15) among subjects with obesity and central obesity. Visceral adipose tissue was a significant risk factor for subsequent chronic kidney disease progression, and the association was identified only in the normal weight group. Normal-weight central obesity was associated with excess risk of chronic kidney disease, similar to the risk in the group with obesity and central obesity.

Frequencies of Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome in Lean Individuals

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) prevalence has doubled in the last 20 years and is becoming a vital health concern due to its increasing prevalence. Lean patients having normal-weight central obesity with NAFLD may have increased morbidity and all-cause mortality and thus form an important target for lifestyle modifications and preventive strategies. Objective: To determine frequencies of NAFLD and Metabolic Syndrome in lean individuals. Methods: The present cross-sectional study was undertaken at the Medicine Department, Pakistan Ordinance Factories Hospital, Wah Cantonment Pakistan from July 2018 to June 2020 enrolling 230 patients aged 20 to 70 years, of both sex. Demographic information, co-morbid conditions, BMI, and waist circumference were recorded. An abdominal ultrasound was performed to determine hepatic fatty infiltration. Blood samples were collected for serum HDL-cholesterol (HDL-C) and serum triglyceride estimation. SPSS 22.0 was used for data entry and analysis. Results: Mean age was 45.7+12.5 years with male predominance at 130 (56.5%). Diabetes mellitus was present in 104 (45.2%) and 102 (44.3%) were hypertensive. The mean BMI was 23.4+3.6 kg/m2. The mean serum triglyceride level was 209+10.1 mg/dl and elevated at 141 (61.3%). The mean serum HDL-C level was 23.1+4.2 mg/dl and was reduced by 142 (61.8%). NAFLD was seen in 38 (16.5%) and 24 (10.4%) had Metabolic Syndrome. Among the 38 lean NAFLD patients, 21 (55.3%) had Metabolic Syndrome. Conclusion: NAFLD was seen in almost one-fifth of lean patients enrolled. Metabolic syndrome was reported in more than one-half of these lean NAFLD patients.

Inflammatory potential of diet and risk of mortality in normal-weight adults with central obesity

Inflammatory potential of diet may contribute to poor health outcomes in individuals with metabolic disorders. In a representative sample of the U.S. population, we investigated the association between consuming a pro-inflammatory diet and mortality risk in adults with normal range of body mass index (BMI) but with central obesity. This prospective cohort study included 3521 adults 20-90 years of age with normal BMI who participated in the National Health and Nutrition Examination Survey III, 1988-1994 and did not have a history of cardiovascular disease (CVD) or cancer and did not change their dietary intake in the year preceding baseline measurements. Mortality from all causes, CVD, and cancer was ascertained from the National Death Index. Normal-weight central obesity (NWCO, n=1777) was defined as those with BMI 18.5 to <25kg/m2 and waist-to-hip ratio (WHR) ≥0.85 in women and ≥0.90 in men. Severe central obesity was defined as WHR ≥0.92 in women and ≥1.00 in men. The dietary inflammatory index (DII®) was computed based on baseline dietary intake using 24-h dietary recalls, and associations with mortality were estimated using multivariable Cox proportional hazards regression. In individuals with NWCO, DII score (i.e., more pro-inflammatory diet) was associated with increased risk of CVD mortality (HRT3 vs T1, 1.89 [95% CI, 1.01-3.53], P trend=0.04; HR 1 SD increase 1.29 [95% CI, 1.06-1.57]). This association was stronger with more severe central obesity (HRT3 vs T1, 2.79 [95% CI, 1.10-7.03], P trend=0.03; HR 1 SD increase 1.52 [95% CI, 1.05-2.21]). DII score was not associated with increased risk of mortality in normal-weight individuals without central obesity or with risk of cancer mortality in either group. Among individuals in the normal-weight range of BMI, a pro-inflammatory diet assessed by high DII scores was associated with increased risk of CVD mortality in those with central obesity.

Staple Food Preference and Obesity Phenotypes: The Regional Ethnic Cohort Study in Northwest China.

Staple food preference vary in populations, but evidence of its associations with obesity phenotypes are limited. Using baseline data (n = 105,840) of the Regional Ethnic Cohort Study in Northwest China, staple food preference was defined according to the intake frequency of rice and wheat. Overall and specifically abdominal fat accumulation were determined by excessive body fat percentage and waist circumference. Logistic regression and equal frequency substitution methods were used to evaluate the associations. We observed rice preference (consuming rice more frequently than wheat; 7.84% for men and 8.28% for women) was associated with a lower risk of excessive body fat (OR, 0.743; 95%CI, 0.669-0.826) and central obesity (OR, 0.886; 95%CI, 0.807-0.971) in men; and with lower risk of central obesity (OR, 0.898; 95%CI, 0.836-0.964) in women, compared with their wheat preference counterparties. Furthermore, similar but stronger inverse associations were observed in participants with normal body mass index. Wheat-to-rice (5 times/week) reallocations were associated with a 36.5% lower risk of normal-weight obesity in men and a 20.5% lower risk of normal-weight central obesity in women. Our data suggest that, compared with wheat, rice preference could be associated with lower odds ratios of certain obesity phenotypes in the Northwest Chinese population.

Status and transition of normal-weight central obesity and the risk of cardiovascular diseases: A population-based cohort study in China

Background and aimsCardiovascular disease (CVD) has become a growing public health concern. Normal weight central obesity (NWCO) has emerged as a potential risk factor for cardiometabolic dysregulation. To date, the association between NWCO and new-onset CVDs remains unclear. We aimed to evaluate the associations of NWCO and its longitudinal transitions with cardiovascular risks in middle-aged and older Chinese. Methods and resultsData were from the China Health and Retirement Longitudinal Study 2011–2018. NWCO was defined as the combination of a body mass index (BMI) of <24.0 kg/m2 and a waist circumference (WC) of >85 cm in males or >80 cm in females. CVDs included heart diseases and stroke. Cause-specific hazard models and subdistribution hazard models with all-cause death as the competing event were applied. In 2011, 9856 participants without prior CVDs were included, of whom 1814 developed CVDs during a 7-year follow-up. Compared to normal weight and non-central obesity (NWNCO), NWCO was significantly associated with new-onset CVDs, with cause-specific hazard ratios (cHRs) and 95% confidence intervals (CIs) of 1.21 (1.04–1.41) for heart diseases and 1.40 (1.11–1.76) for stroke. From 2011 to 2013, 571 NWNCO participants developed NWCO who subsequently demonstrated a 45% higher risk of CVDs than those with maintained NWNCO. ConclusionNWCO and transition from NWNCO to NWCO are associated with higher risks of CVDs. Identification and prevention of NWCO may be useful in the management of CVDs.

Normal Weight Central Obesity among Filipinos and Its Association with Cardiovascular Risk: A Cross-Sectional Study

INTRODUCTION The study aims to measure the prevalence of normal-weight central obesity, to measure its association with cardiovascular risks and diseases and to compare it across the different subtypes of obesity among Filipinos. METHODS The participants were Filipinos age 20 years old above who had participated and completed the desired data in the National Nutrition Survey II. The participants were categorized into the following groups: normal weight (BMI 18.5–24.9 kg/m2) and no central obesity; normal weight with central obesity (WC ≥ 80cm or WHR ≥ 0.85 for females, WC ≥ 90cm or WHR ≥ 0.90 for males); overweight (BMI ≥25-29.9kg/m2); overweight with central obesity; obese (BMI ≥30kg/m2) and obese with central obesity (OBCO). A Binary logistic regression was utilized to determine the odds ratio (OR) and 95% confidence intervals (CI) for hypertension, diabetes, and dyslipidemia. RESULTS A total of 5,920 participants (2,883 men and 3,037 women) were analyzed. The prevalence of normal weight central obesity was 39.3%. In comparison to normal weight, the ORs for hypertension (OR=1.84, p=0.001), diabetes (OR=2.1, p=.001), dyslipidemia (OR=1.3, p=.002), in Obese with central obesity for hypertension (OR=2.2, p=.001), diabetes (OR=2.7, p=.001), dyslipidemia (OR=1.29, p=.10) and in Overweight with central obesity hypertension (OR=1.65, p=.001), diabetes (OR=1.58, p=.001), dyslipidemia (OR 1.28, p=.004) were significantly higher in Normal weight central obesity. CONCLUSION Normal weight central obesity is a common finding among Filipinos and is associated with greater cardiovascular risks of hypertension, diabetes, or dyslipidemia in comparison with obese and overweight. KEYWORDS normal weight central obesity, Filipinos, obesity paradox

Association between Normal Weight Central Obesity and Cardiovascular Disease Risk Factors in Middle-Aged Men

Association between Normal Weight Central Obesity and Cardiovascular Disease Risk Factors in Middle-Aged Men

Causality of anthropometric markers associated with polycystic ovarian syndrome: Findings of a Mendelian randomization study.

Using body mass index (BMI) as a proxy, previous Mendelian randomization (MR) studies found total causal effects of general obesity on polycystic ovarian syndrome (PCOS). Hitherto, total and direct causal effects of general- and central obesity on PCOS have not been comprehensively analyzed. To investigate the causality of central- and general obesity on PCOS using surrogate anthropometric markers. Summary GWAS data of female-only, large-sample cohorts of European ancestry were retrieved for anthropometric markers of central obesity (waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR)) and general obesity (BMI and its constituent variables-weight and height), from the IEU Open GWAS Project. As the outcome, we acquired summary data from a large-sample GWAS (118870 samples; 642 cases and 118228 controls) within the FinnGen cohort. Total causal effects were assessed via univariable two-sample Mendelian randomization (2SMR). Genetic architectures underlying causal associations were explored. Direct causal effects were analyzed by multivariable MR modelling. Instrumental variables demonstrated no weak instrument bias (F > 10). Four anthropometric exposures, namely, weight (2.69-77.05), BMI (OR: 2.90-4.06), WC (OR: 6.22-20.27), and HC (OR: 6.22-20.27) demonstrated total causal effects as per univariable 2SMR models. We uncovered shared and non-shared genetic architectures underlying causal associations. Direct causal effects of WC and HC on PCOS were revealed by two multivariable MR models containing exclusively the anthropometric markers of central obesity. Other multivariable MR models containing anthropometric markers of both central- and general obesity showed no direct causal effects on PCOS. Both and general- and central obesity yield total causal effects on PCOS. Findings also indicated potential direct causal effects of normal weight-central obesity and more complex causal mechanisms when both central- and general obesity are present. Results underscore the importance of addressing both central- and general obesity for optimizing PCOS care.

Relationship of normal-weight central obesity with the risk for heart failure and atrial fibrillation: analysis of a nationwide health check-up and claims database.

AimsThere have been scarce data on the relationship of normal-weight central obesity (NWCO) with the subsequent risk for heart failure (HF) and atrial fibrillation (AF). Using a nationwide health check-up and administrative claims database, we sought to clarify whether NWCO would be associated with the incidence of HF and AF.Methods and resultsMedical records of 1 697 903 participants without prior history of cardiovascular disease (CVD) and normal-weight (body mass index of 18.5–23.0 kg/m2) were extracted from the JMDC Claims Database, which is a health check-up and claims database. We defined NWCO as normal-weight and CO (waist circumference ≥ 90 cm for men or ≥ 80 cm for women). The median age was 44.0 (37.0–52.0) years and 872 578 (51.4%) participants were men. Overall, 154 778 individuals (9.1%) had CO. The mean follow-up period was 3.3 ± 2.6 years. Participants with NWCO were older and more likely to be women than those without. HF and AF occurred in 26 936 (1.6%) and 6554 (0.4%) participants, respectively. People having NWCO were associated with a greater risk for HF [hazard ratio (HR): 1.072, 95% confidence interval (CI) 1.026–1.119] and AF (HR: 1.202, 95% CI: 1.083–1.333) compared with those having normal-weight without CO.ConclusionOur analysis of a nationwide health check-up and administrative claims database including ∼1.7 million participants without prevalent CVD history demonstrated the potential impact of NWCO on the risk for HF and AF, suggesting the importance of abdominal obesity in the developing HF and AF even in normal-weight individuals.

Prevalence of central obesity according to different definitions in normal weight adults of two cross-sectional studies in Panama

Central Obesity (CO) might arise among individuals with normal body mass index (BMI). We aim to estimate the prevalence of Normal Weight CO (NWCO), using different definitions, and to compare its association with cardiometabolic risk factors in the adult population of Panama. Data from two population-based studies conducted in Panama in 2010 and 2019 were used. Using standard definitions, normal weight was defined as a BMI between 18·5 and 24·9 while CO was defined as a Waist-to-Height Ratio (WHtR) ≥ 0·5 in both sexes or a Waist Circumference (WC) ≥ 90, ≥94, or ≥102 cm for men, and 80 or 88 cm for women. Unconditional logistic regression models were used to estimate the association between each CO definition and dyslipidemia, high blood pressure (HBP), diabetes, and clusters of cardiovascular risk factors. Recent CO prevalence ranged between 3·9% (WC ≥ 102 cm for men and WC ≥ 88 cm for women) and 43·9% (WHtR ≥ 0·5) among individuals classify as normal weigh according to the BMI. Different cardiovascular risk factors were present in this normal weight population but among men the threshold of WC ≥ 102 cm screened less than 1·0%. NWCO was associated with cardiovascular risk factors, particularly with elevated concentration of triglycerides. CO evaluation at the primary health care level may be a useful technique to identify normal weight people with metabolically obese characteristics. Gorgas Memorial Institute for Health studies via Ministry of Economy and Finance of Panama and Inter-American Development Bank.