Obesity Indices Research Articles

Association between sleep duration and three obesity indicators among middle-aged and elderly adults: findings from the NHANES 2005–2014

ObjectiveObesity has emerged as a worldwide problem. In recent years, it has been verified that there is an association between sleep duration and obesity indicators. This provides a new approach to control obesity. In this study, the relationship between duration of sleep and body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) among Americans ≥45 years old was investigated.MethodsData was collected from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2014. The link between sleep duration and obesity indicators was analysed using multiple regression models and weighted smoothed curve fitting. Subgroup analysis was conducted to assess the consistency of the connection between sleep duration and obesity indicators across various groups.ResultsThis study involved 7,118 males and 7,265 females, with an average age of 62.09. After total adjustment, sleep duration was negatively correlated with BMI (β = −0.19, 95%CI: −0.26, −0.12), WC (β = −0.36, 95%CI: −0.53, −0.19) and WHtR (β = −0.27, 95%CI: −0.38, −0.17). Subgroup analyses revealed more significant negative associations between sleep duration and BMI, WC, and WHtR among non-Hispanic White participants, and those without diabetes and hypertension.ConclusionSleep duration was significantly negatively associated with BMI, WC, and WHtR, suggesting that longer sleep duration may contribute to lower obesity indicators in middle-aged and elderly Americans. Subgroup analysis showed that their negative correlation differed between races, diabetes, or hypertension status. However, additional prospective studies are required to validate these findings and investigate potential causal relationships.

BS O02 - Impact of Bariatric surgery on Obesity Indices and Reproductive Hormones: A Prospective Study in Morbidly Obese Women

Abstract Background Obesity, defined by a BMI of 30 kg/m² or higher, is influenced by genetics, socio-economic, and cultural factors. Genetic predispositions affect metabolism and energy regulation, while environmental factors like sedentary lifestyles and poor food environments worsen obesity. Obesity disrupts hormonal balances, impacting sex hormone levels and menstrual cycles, leading to infertility in women. This hormonal imbalance affects oocyte quality and ovulation. Bariatric surgery offers significant weight loss and metabolic improvements, enhancing reproductive hormone profiles and insulin sensitivity. Our study explores how sleeve gastrectomy affects BMI and hormone levels, aiming to understand its impact on obesity management and reproductive health. Method This prospective observational study examines the effects of laparoscopic sleeve gastrectomy on reproductive hormones and ovarian function in 32 morbidly obese women, adhering to Helsinki Declaration ethics. Participants, aged 18-50 with no menopause or chronic illness, consented to the study. Exclusions included those with polycystic ovary syndrome, recent reproductive organ surgery, or recent infertility medications. The study assessed changes in BMI, antral follicles, anti-Müllerian hormone, and reproductive hormones before surgery and at 6 and 12 months post-surgery. Blood samples and transvaginal ultrasounds were conducted preoperatively and at 6 and 12 months postoperatively to monitor outcomes. Results The study involved participants with an average age of 33 and a mean BMI of 42.12. Significant changes were observed post-sleeve gastrectomy at 6 and 12 months (p < 0.001). At 6 months, BMI decreased by 9.24 units, AMH levels dropped from 3 to 2.5 ng/mL, and antral follicle counts in both ovaries declined. By 12 months, BMI decreased by 16.47 units, AMH levels fell to 2 ng/mL, and antral follicle counts further reduced. Hormonal changes included increases in FSH, LH, and estradiol, while SHBG levels rose, and free testosterone levels decreased significantly. Conclusion Individual hormone responses to weight loss and surgery necessitate personalized obesity treatments. Tailoring surgical approaches and care to hormonal profiles can optimize outcomes and reduce complications. Monitoring AMH levels post-surgery can offer insights into reproductive effects, aiding clinical management and counseling for women with obesity-related infertility. We highlight the significant impact of sleeve gastrectomy on physiological parameters in obese individuals, especially regarding reproductive health and metabolic regulation. The findings enhance understanding of the changes associated with bariatric surgery and its potential benefits for metabolic and reproductive health.

Abstract 4136677: High Visceral-to-Subcutaneous Fat Ratio is Correlated with Increased Cardiovascular Events in Patients with Low Waist Circumference Suspected of Coronary Artery Disease

Introduction: Waist circumference (WC) has been recognized as an appropriate index of obesity and is closely associated with the amount of abdominal fat. Although abdominal fat distribution (AFD), which is represented by the ratio of visceral adipose tissue (VAT) to subcutaneous adipose tissue (SAT) area (V/S ratio), is possibly related to an increased risk of cardiovascular disease (CVD), few studies have explored the relationship between AFD and CVD outcomes. This study aimed to assess the influence of AFD based on the V/S ratio and physique categorized by WC on long-term clinical results in patients with suspected coronary artery disease (CAD). Methods: We evaluated 931 consecutive patients (mean age, 67 years; 42.4% women) with suspected CAD who underwent computed tomography (CT) angiography. The patients also underwent plain abdominal CT to assess and measure VAT and SAT areas; V/S ratio was calculated to assess AFD. The patients were divided into four groups based on the median V/S ratio (0.624) and reference values of WC for metabolic syndrome in Japan (85 cm for men, 90 cm for women). We assessed the relationship between the V/S ratio and long-term clinical outcomes in each WC group. The main outcome was major adverse cardiac events (MACEs, including cardiac death, any coronary revascularization, acute coronary syndrome, and emergency hospitalization due to cardiac cause). Results: Over a median follow-up of 1869 days, although the incidence of any cardiovascular event was not related to the V/S ratio among patients with high WC, a higher incidence of MACE and cardiac death was noted among patients with low WC in the high V/S ratio group than in the low V/S ratio group. Furthermore, Kaplan–Meier analysis revealed a significantly lower MACE-free survival rate among patients with low WC in the high V/S ratio group than in the low V/S ratio group, despite of no differences being noted among high WC patients in both the V/S ratio groups (Figure). Conclusion: Only in patients with low WC, a high V/S ratio was linked to increased risks of MACE. Thus, high V/S ratio may be an essential risk factor for CVD, specifically in patients with low WC. However, AFD did not influence CVD prognosis in patients with high WC.

Abstract 4138570: The Hidden Killer in Patients with Sepsis Spectra Disorders: Systolic Heart Failure

Introduction: Sepsis and systolic heart failure (sHF) often prompt hospitalization and require near diametrically opposite treatment strategies. We, therefore, studied whether sHF would impact outcomes in patients with sepsis spectra. Methods: We examined the National Inpatient Sample 2021 for adults admitted with sepsis spectra (sepsis, severe sepsis, and septic shock). We compared patients with sHF vs those without. STATA 18 th edition was used for analyses. Age, gender, race, hypertension, diabetes, obesity, dyslipidemia, and Elixhauser comorbidity index were identified as confounders by univariate analyses and tested further with multivariate logistic regression models. The primary outcome was mortality. Secondary outcomes were the need for intubation, cardiac arrest, length of stay (LOS), and total hospital charges. Results: In 2021, nationwide, 3,030,351 adults were admitted for sepsis spectra, and 209,134 (6.9%) had concomitant sHF. Patients with sHF and sepsis spectra (as compared to those without sHF) were less likely female (35.5% vs. 48%), had a substantially higher likelihood of a prior MI, and nearly 50% were diabetic and hyperlipidemic with a higher comorbidity index. Baseline characteristics are in the Table. Sepsis and sHF resulted in substantially higher mortality (22.7%) as compared to patients with sepsis alone (14.9%) adjusted odds ratio (aOR) of 1.11 (CI 1.08-1.14; p-value < 0.001). Patients with sepsis and sHF were more likely to require intubation 22.2% vs. 14.0% aOR 1.21 (CI 1.18-1.25; p-value < 0.001), had more cardiac arrest 7.7% vs. 4.0% aOR 1.38 (CI 1.32-1.44; p-value < 0.001), and a longer LOS (11.9 vs 9.4 days adjusted incidence rate ratio (aIRR) 1.06; CI 1.05 – 1.08; p-value < 0.001). Consequently, total hospital charges were also higher, $189,415 vs $133,720, aIRR 1.15 (CI 1.13-1.18; p-value < 0.001). Conclusion: In 2021, nationwide, sepsis spectra remain a major cause of in-patient mortality. We demonstrate that the coexistence of systolic heart failure and sepsis dramatically worsens complications, mortality, and total hospital costs. This study is a call to action for the in-depth analyses of this very high-risk group of patients.

Abstract 4144525: An Observation Of Racial Disparities In Patients Admitted With St Segment Elevated Myocardial Elevation

introduction: This sudy explores the multifaceted nature of racial disparities among patients admitted with STEMI, shedding light on the complex interplay of social, economic, and healthcare factors that contribute to differential outcomes among diverse populations. Methods: we examined the national inpatient sample 2017-2020 for adult admitted with st segment myocardial infarction,we compared the clincal outcome based on racial distribution.STATA 18th edition was used for analyses. Age, gender, race, hypertension, diabetes, obesity, dyslipidemia, and Elixhauser comorbidity index were identified as confounders by univariate analyses and tested further with multivariate logistic regression models. The primary outcome was mortality. Secondary outcomes were the need for intubation, cardiac arrest, length of stay (LOS), and total hospital charges. Results: There were 826315 hospitalizations with STEMI. Mean age was 64 yrs and 62% were male. Among the admitted patients, Caucasians were 593575 (72%), Blacks were 75025(9.1%),Hispanics were 69605(8.4%), Asians were 23734(2.9%). All-cause mortality in patients admitted with STEMI was 88125 where subgroup Analysis with Caucasians, Blacks ,Hispanics and Asians had 60074(10.1%) vs 9135 (12.1%) vs 7645(10.9%) and 2999(12.6%) respectively. Further subgroups analysis revealed that Blacks (13.9%, aOR 1.37 CI 1.28-1.47,P value<0.001) were more likely to require intubation,followed by Asians(13.5% aOR 1.59 CI 1.43--1.76, p value <0.001) ,then Hispanic (13% aOR 1.45,CI 1.35-1.56 P vale <0.001)and caucasians were least likely to require intubation(9.7% ) Finally, racial subgroup showed significant primary andsecondary outcomes that are presented in Table 1. Conclusion: All obtained results revealed statistical significance and we considered Caucasian population as baseline. Mortality waa highest amongst Asians,followed by Blacks then Hispanics and least in the caucasian subgroup. Understanding these disparities is essential for improving healthcare equity and ensuring that all patients receive appropriate and equitable care regardless of their racial or ethnic background.

The association between food production, food security, household consumer behaviour and waist‐hip ratio amongst women in smallholder farming households in Kilifi County, Kenya

AbstractFood insecurity disproportionately affects smallholder farming households and within them women, who bear primary caregiving responsibilities and contend with time and resource constraints that heighten their vulnerability to adverse nutrition‐related health outcomes. This study cross‐sectionally investigates the association between food production practices, household consumer behaviour, and the experience of food insecurity with women's waist‐hip ratio (WHR), a key indicator of abdominal obesity, in a coastal community in Kenya. In total, 394 households were randomly selected from a list of farming households in Kaloleni and Rabai sub‐counties of Kilifi. Trained enumerators administered questionnaires to adult female family members who play a pivotal role in household management. Household dietary diversity scores (HDDS) were computed from 16 food groups consumed in the 7 days preceding the survey. Waist‐hip measurements focused on these females, representing vulnerable populations. Pathway‐based regression models were constructed using STATA version 13 (p < 0.05). Most households practised mixed farming (59.9%) and monocropping (73.2%) and most female respondents were widowed (75.1%) with limited education (73.1% had no formal education) and over 20 years of farming experience. Food insecurity was prevalent, affecting 80.7% of households. Limited dietary diversity was noted with an average HDDS of 9. The most commonly consumed foods were cereals, spices, condiments and beverages, while meat, eggs and fruits were infrequently eaten. An inverse association was observed between HDDS and WHR (standardised regression coefficient = −0.1328; p = 0.026) but while food insecurity was inversely associated with both HDD and WHR, these associations did not reach statistical significance (HDDS‐standardised regression coefficient −0.0294; p = 0.592: WHR‐standardised regression coefficient −0.0155; p = 0.791). Existing research has primarily addressed the undernutrition and hunger‐related impacts of food insecurity. The findings underscore the need to better understand the complex interplay between food insecurity and nutritional health, including markers of adiposity, to effectively promote health.

Prevalence of Chronic Liver Disease Based on Ultrasound Shear Wave Elastography in an Adult Asian Indian Population Attending Outpatient Preventive Radiology Clinics in India.

To determine the ultrasound shear wave elastography (SWE)-based prevalence of chronic liver disease in an adult Asian Indian population attending preventive radiology outpatient clinics in India. Liver stiffness measures (LSMs) were ascertained using ultrasound SWE and interquartile range/median (IQR/M) ratio ≤ 30% kilopascal (kPa) units were considered a good quality measurement. Details of modifiable risk factors including comorbidity and personal risk behaviors were collected. The liver was graded based on the Society of Radiologists in Ultrasound Liver Elastography Consensus Statement and Grades 4 and 5 indicated compensated advanced chronic liver disease (cACLD) and clinically significant portal hypertension (CSPH). A multivariate logistic regression model was used to analyze associations with chronic advanced liver disease. The median LSM in the study participants (n = 1145) was 8.0 (IQR 6.5, 9.85) kPa units. 10.65% of the study population had advanced chronic liver disease (cACLD and CSPH) and 22.79% had LSM that was suggestive of cACLD. cACLD and CSPH were significantly associated with comorbidities, personal risk behaviors, and lean and obese body mass indices. Modifiable risk factors were present in 20%-50% of participants with LSM between 7 and 13 kPa. Information on the prevalence of LSM-based cACLD and CSPH and modifiable risk factors in persons with LSM between 7 and 13 kPa will help to design preventative strategies using LSM as an objective imaging biomarker.

Effect modifications of parents’ age at childbirth on association between ambient particulate matter and children obesity

BackgroundThere is limited evidence regarding the modifying effects of parents’ age at childbirth on the relationship between air pollution and obesity in plateau areas. This study aimed to explore the association between particulate matter (PM) and child obesity, specifically investigating whether parents’ age at childbirth could modify this relationship in the Tibetan plateau, China.MethodsSatellite-based random forest models were used to estimate the concentrations of PM2.5 (particulate matter with aerodynamic diameters ≤ 2.5 μm), PMc (particulate matter with aerodynamic diameters between 2.5 μm and 10 μm), and PM10 (particulate matter with aerodynamic diameters ≤ 10 μm). Linear and logistic regression models were employed to assess associations between PM exposure and obesity indicators, and effect estimates of PM across different particle sizes were compared.ResultsThe study comprised 2,015 children under five years old. Postnatal exposure to PM was positively associated with overweight and obesity (OWO), waist-to-hip ratio (WHR) and body mass index (BMI). Among these pollutants, PM10 exhibited the strongest association with BMI and OWO, whereas PMc showed the strongest association with WHR. An interquartile range (IQR) increase in PM2.5 (5.67 µg/m3), PMc (5.25 µg/m3), and PM10 (11.06 µg/m3) was positively associated with OWO (odd ratio [OR] for PM2.5 = 1.52, 95% confidence interval [CI] for PM2.5 = 1.24 to 1.85; OR for PMc = 1.50, 95% CI for PMc = 1.19 to 1.88; OR for PM10 = 1.56, 95% CI for PM10 = 1.25 to 1.96), respectively. Stratified analysis by parents’ age at childbirth indicated that the effects of PM on obesity indicators were more pronounced in the advanced age group.ConclusionsLong-term exposure to PM was positively associated with OWO, WHR, and BMI. Our findings also underscore the importance of examining the effects of ambient PM exposure on OWO, particularly in parents of advanced age at childbirth.

The role of obesity in mortality from digestive diseases in UK Biobank

Most current studies use body mass index (BMI) or waist circumference (WC) to define obesity, and BMI, which reflects subcutaneous fat independent of visceral fat, is the most commonly used indicator of obesity. WC reflects subcutaneous and visceral fat. This research aims to investigate the effect of obesity on mortality in people with digestive diseases. According to BMI and WC, we divided patients with obesity into the following four groups: general obesity, abdominal obesity, combined obesity, and non-obese. The effects of different obesity types on mortality in a population with digestive diseases were analysed via Cox regression and inverse probability-weighted Cox regression. Our research employed multivariate imputation via the chained equations method to interpolate missing values. A total of 254,445 participants, with a mean age of 57.8 ± 7.8 years, were included in the analysis. Of these participants, 227,111 (89.3%) participants were censored, and 27,334 (10.7%) participants died. Abdominal obesity and combined obesity were independent predictors of mortality in patients with digestive diseases. The combination of BMI and WC was valuable and significant for considering the type of obesity. In addition, our study revealed that sex, socioeconomic status, lifestyle habits, and physical activity were also associated with death in people with digestive disorders. Combined obesity, which is determined by both BMI and WC, is an important factor that influences mortality in a population with digestive diseases, and it plays a stronger role than abdominal obesity alone. These modifiable risk factors for mortality can provide guidance to populations with digestive diseases to avoid poor lifestyles and prolong survival time.

Association between cardiometabolic index (CMI) and periodontitis in US adults: analysis of NHANES data (2009–2014)

BackgroundThe cardiometabolic index (CMI) is a new predictor of obesity-related diseases, but its link to periodontitis is under-researched. This study aims to examine the potential association between the CMI and periodontitis.MethodsWe conducted a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES) database (2009–2014) to examine the potential association between CMI and periodontitis. The study utilized a weighted multivariate logistic model to assess the association between TG, HDL-C, TG/HDL-C, obesity indices (BMI, WC, WHtR, CMI), and periodontitis, employing the area under the receiver operating characteristic curves (ROC) to estimate areas under the curve (AUC). Furthermore, generalized smooth curve fitting was conducted to examine the relationship between CMI and periodontitis. Finally, the study incorporated subgroup analysis and interaction tests to examine consistency across different populations.ResultsTG/HDL-C, WHtR, and CMI were positively associated with periodontitis in the fully adjusted classification model. It was observed that for each unit increase in CMI, there was a corresponding 17.8% increase in the prevalence of periodontitis [1.178 (1.049, 1.322) 0.00562] and 18.7% increase in the prevalence of moderate/severe [1.187 (1.057, 1.334) 0.00376] in the fully adjusted model. When CMI was used as a categorical variable, the adjusted OR for periodontitis prevalence increased significantly with increasing CMI after adjusting for all potential covariates (T3 vs. T1: OR, 1.28 [1.06, 1.55], p < 0.05). The ROC analysis indicated that a larger area under the curve was found in the CMI [0.554 (0.538–0.570)] than in the WC [0.544 (0.528–0.560)] and WHtR [0.544 (0.528–0.561)]. Nonetheless, the discrepancy observed did not reach statistical significance (all p > 0.05). Further generalized smooth curve fitting and threshold effect models indicated a positive linear correlation between CMI and periodontitis. Moreover, there is no interactive association between TG/HDL-C, WHtR, CMI, and periodontitis.ConclusionsThis cross-sectional study revealed a positive relationship between CMI and periodontitis. Further prospective studies are warranted to validate our findings.

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

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

Novel Adiposity Indices Are Associated With Poor Prognosis in Heart Failure With Preserved Ejection Fraction Without the Obesity Paradox.

There is limited study that illuminates the relationship between obesity indices and prognosis in patients with heart failure with preserved ejection fraction, nor has it been examined whether the obesity paradox persists when using these metrics. This study is a post hoc analysis of data from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial. A total of 3114 individuals were included in our final analysis, and a total of 481 (15.4%) all-cause deaths, and 389 (12.5%) heart failure hospitalizations were recorded. In a multivariable Cox regression model, compared with patients with a body mass index (BMI) <24.9 kg/m2, those with a BMI of 25.0-29.9, 30.0-34.9, and 35-39.9 kg/m2 were associated with a decreased risk of all-cause death, with hazard ratio (95% CI) of 0.59 (0.45-0.78), 0.61 (0.46-0.82), and 0.66 (0.47-0.92), respectively. Conversely, patients with a BMI ≥40 kg/m2 showed an increased risk of heart failure hospitalization, compared with BMI <24.9 kg/m2. Furthermore, patients in the highest quintile of obesity indices exhibited a significantly elevated hazard ratio for both all-cause death and heart failure hospitalization, compared with the lowest quintile. An elevated BMI over a certain range was associated with a reduced risk of all-cause death in heart failure with preserved ejection fraction, displaying a U-shaped relationship, with no mortality reduction observed in cases of extreme obesity. In contrast, higher values of novel obesity indices were positively correlated with all-cause death and heart failure hospitalization without the obesity paradox.

Effect of abnormal distribution of abdominal adiposity and skeletal muscle on the outcomes of endovascular treatment for emergent large vessel occlusion

BackgroundThe aim of this study was to investigate the relationships between imaging indicators of obesity, as measured by computed tomography (CT), and clinical outcomes at 90 days and 1 year...

Relationship between physical activity and abdominal obesity and metabolic markers in postmenopausal women

This study aimed to investigate the impact of physical activity indicators monitored by the POLAR accelerometer on body obesity indicators, metabolic syndrome parameters, and energy metabolism hormones in postmenopausal women. Was included 71 participants from this study program (68.8 ± 4.3 years). We divided participants into LPA and MVPA groups based on their level of moderate to vigorous physical activity per week; Physical activity levels over 7 days were assessed using a POLAR accelerometer, with daily step counts and sedentary time recorded. Measurements included waist circumference, visceral fat volume, body fat percentage, blood pressure, fasting blood glucose, triglyceride levels, HDL cholesterol, and energy metabolism hormone levels (leptin, resistin, adiponectin). The MVPA group displayed lower waist circumference, body fat percentage, abdominal fat, and BMI compared to the LPA group (p < 0.05). A significant negative correlation was observed between daily step count and obesity indicators, including waist circumference (r = -0.301), body fat percentage (r = -0.295), abdominal fat (r = -0.318), and BMI (r = -0.238). Conversely, sedentary time showed a positive correlation with obesity indicators such as waist circumference (r = 0.258), body fat percentage (r = 0.239), and abdominal fat (r = 0.244). Moreover, daily step count exhibited a significant negative correlation with leptin levels (r = -0.245), while sedentary time was positively correlated with the energy metabolic factor leptin (r = 0.279). Waist circumference demonstrated significant positive correlations with triglycerides, blood glucose, adiponectin, resistin, and leptin levels. Postmenopausal women who engage in at least 150 min of MVPA weekly show lower obesity indices. There is a significant correlation between physical activity levels and obesity indicators, which relate to metabolic syndrome and energy metabolism factors. Thus, increased physical activity may help prevent metabolic syndrome and cardiovascular diseases in this population.

Association of body indices with mortality in older population: Japan Specific Health Checkups (J-SHC) Study.

Obesity indices reflect not only fat mass but also muscle mass and nutritional status in older people. Therefore, they may not accurately reflect prognosis. This study aimed to investigate associations between a body shape index (ABSI), body mass index (BMI), and mortality in the general older population. This nationwide observational longitudinal study included individuals aged between 65 and 74 years who underwent annual health checkups between 2008 and 2014. Exposures of interest were ABSI and BMI, and the primary outcome was all-cause mortality. Association between the ABSI and BMI quartile (Q1-4) and mortality was assessed using Cox regression analysis. A restricted cubic spline was also used to investigate nonlinear associations. The missing values were imputed using multiple imputation by chained equations. Among 315,215 participants, 5074 died during a median follow-up period of 42.5 (interquartile range: 26.2-59.3) months. Compared with ABSI Q1, ABSI Q3 and Q4 were associated with increased risk of mortality, with the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of 1.13 (1.05-1.22) and 1.23 (1.13-1.35), respectively. Compared with BMI Q3, BMI Q1 and Q2 were associated with an increased risk of mortality, with aHRs and 95% CIs of 1.51 (1.39-1.65) and 1.12 (1.03-1.22), respectively. The impacts of these indices were greater in male than in female. The heatmap of the aHR for mortality by continuous ABSI and BMI showed that higher ABSI was consistently associated with higher mortality risk regardless of BMI, and that the combination of low BMI and high ABSI was strongly associated with increased mortality risk. High ABSI and low BMI are additively associated with the risk of all-cause mortality in the general older population in Japan. Combination of ABSI and BMI is useful for evaluating mortality risk in older people.

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

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

Trajectories of Obesity Indices and Their Association with Pain in community-dwelling older adults: Findings from the English Longitudinal Study of Ageing

BackgroundThe prevalence of pain has increased with the increase of obesity, and finding indicators to predict pain risk has become an urgent need. BMI, WC, and WHtR have the potential to be excellent predictors. However, the association of these obesity indicators with various pains remains unclear. MethodsThis longitudinal cohort study included 2,155 pain-free participants (mean age = 68.5 years, standard deviation [SD] = 8.6) from the English Longitudinal Study of Ageing (ELSA). BMI, WC, and WHtR were measured during nurse visits at waves 0, 2, and 4. The Group-Based Trajectory Model (GBTM) was used to identify optimal trajectories for BMI, WC, and WHtR. Self-reported pain at four anatomical sites (lower back, hip, knee and total pain) was assessed at Waves 4 to 9. Cox proportional hazards models were employed to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between obesity indices and pain risk. ResultsOver a median follow-up period of 7.49 years, we observed 1,059 incident cases of all-cause pain. After adjusting for confounders, participants in the High-Stable WC group had a 30% higher risk of experiencing pain (HR: 1.30, 95% CI: 1.05–1.60, P = 0.014), while those in the High-Stable WHtR group had a 29% higher risk (HR: 1.29, 95% CI: 1.06–1.56, P = 0.010) compared to the Low-Stable group. High-stable trajectories for BMI, WC, and WHtR were also associated with an elevated risk of back, hip, and knee pain. ConclusionThis study identifies long-term obesity indices as significant predictors of pain, suggesting the importance of monitoring these measures for effective clinical risk assessments. Further research is needed to explore the underlying mechanisms of these associations.

Triglyceride-glucose Index and Its combination with obesity indicators mediating the association between 2-hydroxyfluorene and the prevalence of cardiovascular disease: Evidence from the NHANES (2005–2018)

BackgroundPolycyclic aromatic hydrocarbons (PAHs) were increasingly recognized as a group of environmental pollutants associated with various health issues. The rise in their prevalence in the environment was concerning. Yet, the effects of PAH exposure on cardiovascular diseases (CVDs) were still not well understood. PurposeThis study investigated the impact of exposure to 2-hydroxyfluorene on CVDs prevalence, with a special focus on the mediating role of triglyceride-glucose (TyG) index and its combination with obesity indicators. MethodUsing National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018, this study assessed how 2-hydroxyfluorene affects CVDs prevalence through various statistical techniques. The investigation began with restricted cubic spline (RCS) analysis to explore the relationship between 2-hydroxyfluorene levels and CVDs prevalence. Logistic regression was then used to examine associations within PAH mixtures, alongside the Bayesian Kernel Machine Regression (BKMR) model. Furthermore, the Quantile G-Computation (QG-comp) model was used to evaluate the influence of weights and directions. A mediation analysis was also performed to assess the mediating role of TyG-related indicators on the relationship between 2-hydroxyfluorene and CVDs prevalence. Besides, the association between 2-hydroxyfluorene and the prevalence of each specific CVDs, congestive heart failure, myocardium infarction, angina pectoris and coronary heart disease, was also assessed and so was the mediated effect. Finally, the subgroup analysis was conducted to assess the association in each specific subgroup. ResultThe study, involving 3645 participants, found a significant positive association between 2-hydroxyfluorene exposure and CVD (OR (95 %CI) = 115.8013 (5.0521 ∼ 2654.3248), P=0.0029), with 2-hydroxyfluorene showing the positive contribution to CVDs prevalence within the phthalate mixture. The positive association also existed between 2-hydroxyfluorene and the prevalence of each specific CVDs. TyG and TyGWC (Triglyceride Glucose-Waist Circumference) were identified as mediators in the link between 2-hydroxyfluorene exposure and the prevalence of total CVD and each specific CVD, while TyGBMI (Triglyceride Glucose-Body Mass Index) can only mediate the association between 2-hydroxyfluorene and the prevalence of total CVD, congestive heart failure and angina pectoris ConclusionThe findings highlighted a significant association between 2-hydroxyfluorene exposure and CVDs prevalence, with TyG-related indicators acting as mediators.

Associations between Chinese Visceral Adiposity Index and incident stroke among community populations in Pudong New Area, Shanghai

BackgroundTo analyze the relationship between Chinese Visceral Adiposity Index (CVAI) and stroke in Pudong New Area, and to provide a scientific basis for the prevention and treatment of this condition. Materials and MethodsBased on the Follow-up Cohort Program of Chronic Disease Risk Factors in Pudong New Area, a total of 7,194 residents from 12 townships and 35 village committees or neighborhood committees were selected. The cohort data in 2016 served as the baseline, and a follow-up was conducted on 5462 individuals from 2019 to 2020. ResultsIn the analysis of stroke incidence, 5,462 subjects were included, with 616 stroke events recorded. The incidence density of stroke was 33.41 per 1000 person-years, while the China standard rate and the world standard rate were 13.78 and 12.52 per 1000 person-years, respectively. The incidence density of stroke rose with increasing quartiles of CVAI. After adjusting for potential confounders, the risk of stroke for males and females with CVAI ≥ 132.11 was 2.492 times (95% CI: 1.457 ∼ 4.260) and 1.759 times (95% CI: 1.070-2.891), respectively, compared to the groups with CVAI < 81.91. Among the eight obesity indicators, including CVAI, Visceral Adiposity Index (VAI), Body Mass Index (BMI), Waist Circumference (WC), Waist Hip Ratio (WHR), Waist Height Ratio (WHtR), Body Adiposity Index (BAI), A Body Shape Index (ABSI),and Body Roundness Index (BRI), CVAI has the highest diagnostic accuracy for female stroke using Receiver Operator Characteristic (ROC) curves (the Area under the ROC curve/AUC = 0.619). Subgroup analysis showed that smoking and dyslipidemia significantly modified the association between CVAI and stroke risk in females (interaction P < 0.05). ConclusionsCVAI is identified as a significant risk factor for stroke and serves as a valuable predictor of stroke, particularly in females.

Atherogenic Index of Plasma (AIP): The Most Accurate Indicator of Overweight and Obesity Among Lipid Indices in Type 2 Diabetes-Findings From a Cross-Sectional Study.

This study aimed to evaluate the relationships of conventional and calculated lipid indices with obesity or overweight in patients with type 2 diabetes (T2D). In this cross-sectional study, all participants were categorised into three groups: normal weight (18 ≤ BMI < 25), overweight (25 ≤ BMI < 30) and obese (BMI ≥ 30). Conventional lipid indices, including triglyceride (TG), total cholesterol, LDL-C and HDL-C, were measured. Lipid indices, including the atherogenic index of plasma (AIP), non-HDL-C, TC/HDL-C, LDL-C/HDL-C, non-HLD-C/HDL-C (atherogenic index, AI) and lipoprotein combine index (LCI), were calculated. The associations of these lipid indices with obesity and overweight status were evaluated using univariate and multivariate multinomial logistic regression analyses. In this study, 2661 patients with T2D, including 651 patients with normal weight, 1144 with overweight, and 866 with obesity, were recruited. According to a multinomial logistic regression analysis after adjustment for multiple confounders, the odds ratio (OR) was greater for the AIP than for other conventional and calculated lipid indices in overweight and obese patients with T2D. The AIP had a significant relationship with overweight, with an OR of 4.79 (95% CI: 1.65-13.85), and it had a significant relationship with obesity, with an OR of 13.64 (95% CI: 3.96-47.04). According to the ROC curve, with a cut-off value of 0.68, AIP could predict obesity with 82% sensitivity and 55% specificity (AUC = 0.770, 95% CI: 0.729-0.812, p < 0.001). Compared with other conventional and calculated lipid markers, the AIP is most strongly associated with obesity and overweight in patients with T2D.