Obesity Indices Research Articles

Association of a body shape index with femur bone mineral density among older adults: NHANES 2007-2018.

A body shape index (ABSI) is an abdominal obesity index developed based on epidemiological statistics and high ABSI indicates that waist circumference (WC) is higher than expected for a given height and weight and corresponds to a more central concentration of body volume. The objective of this study was to determine whether there is a linear or nonlinear relationship between ABSI and total femur bone mineral density (BMD) in older Americans and whether the relationship between the ABSI and total femur BMD varies across populations. This cross-sectional study was based on data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Weighted multiple linear regression, restricted cubic spline (RCS) curves, subgroup analysis, and interaction tests were used to examine the association between ABSI and total femur BMD. This study included 2505 older adults. This study found a negative linear correlation between ABSI and total femur BMD (β = -3.2, 95%CI: -5.0, -1.4, p < 0.001). When participants were grouped according to quartiles of ABSI, those in the upper quartile had lower total femur BMD compared to those in the bottom quartile of ABSI. This negative association remained consistent across gender, age, education level, smoking, physical activity and BMI subgroups. However, in the diabetes subgroup, ABSI showed a stronger negative association with total femur BMD. The study shows a negative linear association between ABSI and total femur BMD in older Americans, with this negative association being stronger in the diabetic population.

High Obesity Indices Are Associated with Gastroesophageal Reflux Disease, but Low Obesity Indices Are Associated with Peptic Ulcer Disease in a Large Taiwanese Population Study

Introduction: Gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD) are prevalent in Taiwan. Few studies have investigated the associations between obesity indices with GERD and PUD simultaneously. This study aimed to investigate the correlations among obesity indices with GERD and PUD in a large cohort of participants, around 120,000, in the Taiwan Biobank (TWB). Methods: A total of 121,583 participants (male: 43,698; female: 77,885; mean age 49.9 ± 11.0 years) were included to analyze the associations among obesity indices, including body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), abdominal volume index (AVI), lipid accumulation product (LAP), visceral adiposity index (VAI), and triglyceride-glucose index (TyG index), with GERD and PUD. Self-reported GERD and PUD were obtained by questionnaires. Multivariate logistic regression analysis was employed to analyze the relationship between obesity indices with GERD and PUD. Results: The prevalence of GERD and PUD was 13.7% and 14.6%, respectively. After multivariable analysis, high WHR (odds ratio [OR] = 1.009, p < 0.001), WHtR (OR = 1.005, p = 0.003), BRI (OR = 1.022, p = 0.005), AVI (OR = 1.013, p < 0.001), LAP (OR = 1.001, p < 0.001), TyG index (OR = 1.068, p < 0.001), and VAI (OR = 1.013, p = 0.002) were significantly associated with GERD, except BMI (p = 0.384). On the other hand, low BMI (OR = 0.984; p < 0.001) and AVI (OR = 0.994; p = 0.036) were significantly associated with PUD. However, the values of WHR (p = 0.151), WHtR (p = 0.304), BRI (p = 0.452), LAP (p = 0.799), VAI (p = 0.347), and TyG index (p = 0.642) were not. Conclusion: This study found that high obesity indices are associated with GERD, but low obesity indices are associated with PUD in a large Taiwanese population study. Our findings may alert physicians to notice that different obesity index may be associated with different gastrointestinal disorder.

Evaluating the efficacy of surgical and conservative approaches in mild autonomous cortisol secretion: a meta-analysis.

The management of Mild Autonomous Cortisol Secretion (MACS) remains a topic of debate among clinicians, with differing opinions on the effectiveness of surgical intervention compared to conservative treatment methods. This meta-analysis provides a comprehensive assessment of available literature to determine the most effective approach for treating this condition. On December 1, 2023, an exhaustive literature search of English databases Embase, PubMed, the Cochrane Library, Scopus, Web of Science, as well as the Chinese databases China HowNet, Wanfang Database, SinoMed Database, and Weipu Database using the keywords "Mild Autonomous Cortisol Secretion", "Subclinical Cushing's Syndrome", "Subclinical Hypercortisolism", "Mild Cortisol Autonomous Secretion", "Adrenal Incidentaloma", "Surgical Treatment" and "Adrenalectomy". The data were statistically analyzed using STATA version 15.0. In this comprehensive analysis involving 629 patients with MACS, the therapeutic efficacy of adrenalectomy was evident. The meta-analysis results indicate that compared to conservative treatment, surgical intervention more effectively improves obesity indicators in patients: waist circumference (SMD=-0.62, 95% CI: -1.06 to -0.18), BMI (SMD=-0.41, 95% CI: -0.62 to -0.20), enhances glycemic control: fasting blood glucose (SMD=-0.47, 95% CI: -0.68 to -0.26), glycated hemoglobin (SMD=-0.66, 95% CI: -0.95 to -0.38), improves lipid metabolism: triglycerides (SMD=-0.45, 95% CI: -0.73 to -0.16), lowers blood pressure: systolic blood pressure (SMD=-1.04, 95% CI: -1.25 to -0.83), diastolic blood pressure (SMD=-0.89, 95% CI: -1.12 to -0.65), and ameliorates hormonal metabolic disorder: 24h urinary free cortisol (SMD=-1.10, 95% CI: -1.33 to -0.87), ACTH (SMD=2.30, 95% CI: 1.63 to 2.97). All these differences are statistically significant. This meta-analysis shows that, compared to conservative treatment, surgical treatment is more effective in improving obesity indicators, glycemic control, lipid metabolism, reducing blood pressure, and ameliorating hormonal metabolic disorders in patients with MACS. These statistically significant results highlight the importance of considering surgical intervention in the management of patients with MACS. https://www.crd.york.ac.uk/prospero, identifier CRD42023492527.

Association between triglyceride glucose-waist height ratio index and cardiovascular disease in middle-aged and older Chinese individuals: a nationwide cohort study

BackgroundThe triglyceride-glucose (TyG) index and its combination with obesity indicators can predict cardiovascular diseases (CVD). However, there is limited research on the relationship between changes in the triglyceride glucose-waist height ratio (TyG-WHtR) and CVD. Our study aims to investigate the relationship between the change in the TyG-WHtR and the risk of CVD.MethodsParticipants were from the China Health and Retirement Longitudinal Study (CHARLS). CVD was defined as self-reporting heart disease and stroke. Participants were divided into three groups based on changes in TyG-WHtR using K-means cluster analysis. Multivariable binary logistic regression analysis was used to examine the association between different groups (based on the change of TyG-WHtR) and CVD. A restricted cubic spline (RCS) regression model was used to explore the potential nonlinear association of the cumulative TyG-WHtR and CVD events.ResultsDuring follow-up between 2015 and 2020, 623 (18.8%) of 3312 participants developed CVD. After adjusting for various potential confounders, compared to the participants with consistently low and stable TyG-WHtR, the risk of CVD was significantly higher in participants with moderate and increasing TyG-WHtR (OR 1.28, 95%CI 1.01–1.63) and participants with high TyG-WHtR with a slowly increasing trend (OR 1.58, 95%CI 1.16–2.15). Higher levels of cumulative TyG-WHtR were independently associated with a higher risk of CVD events (per SD, OR 1.27, 95%CI 1.12–1.43).ConclusionsFor middle-aged and older adults, changes in the TyG-WHtR are independently associated with the risk of CVD. Maintaining a favorable TyG index, effective weight management, and a reasonable waist circumference contribute to preventing CVD.

Visceral Adiposity and Its Impact on Nephrolithiasis: A Narrative Review.

Kidney stones represent a serious medical problem, resulting from several factors such as diet, genetics, and certain medical conditions. Visceral adipose tissue has been shown in recent research to play a significant role in kidney stone formation, making it a more precise indicator than traditional obesity indicators such as body mass index. The main aim of this review is to summarize studies on visceral obesity as a predictive marker for nephrolithiasis and to highlight new mechanistic pathways such as adipokine-mediated inflammation and its impact on kidney stone formation. This review emphasizes the importance of considering visceral fat in the prevention and management of kidney stones, suggesting that targeted strategies to reduce visceral fat could decrease the incidence of kidney stones and their management costs. Further prospective studies are needed to validate these findings and propose preventive strategies based on visceral adiposity assessments.

Obesity and adiposity promote the development of non-suppurative otitis media: a Mendelian randomization study.

Observational studies have found that obesity is associated with the development of non-suppurative otitis media (NSOM), but the causality and pathogenesis are unclear. This study aimed to investigate the association between obesity, lipid metabolism, and NSOM at the genetic level. We performed a bidirectional two-sample Mendelian randomization (MR) study to examine the causal relationship between obesity, lipid metabolism-related factors, and NSOM by using the datasets obtained from the IEU Open genome-wide association studies (GWAS) Project. Furthermore, a multivariate MR (MVMR) analysis on lipid indicators was conducted to validate the results. We then used obesity or body mass index (BMI) as the exposure and NSOM as the outcome to search for possible mediators in lipids and adipokines. Using NSOM as the outcome, we found nine positive exposure results related to obesity and lipid metabolism. Among them, obesity, BMI, body fat percentage, waist circumference, hip circumference, and resistin were risk factors, while apolipoprotein A1 (apoA1), high-density lipoprotein cholesterol (HDL-C), and nerve growth factor (NGF) were protective factors. Then, we used the obesity and lipid metabolism-related factors as outcomes and NSOM as the exposure to perform the MR analysis, which failed to obtain positive results. In the MVMR analysis, we found that HDL cholesterol and apoA1 remained causally associated with NSOM after correction for other potential confounders. Simultaneously, when obesity or BMI was used as the exposure and NSOM as the outcome, HDL cholesterol or apoA1 served as mediators through a two-step MR analysis. The MR analysis for mediation, obesity, and BMI reduced the production of HDL or apoA1, which served as protective factors affecting the development of NSOM. At the genetic level, obesity and adiposity may promote the development of NSOM, while NSOM has no effect on obesity and adiposity. Obesity can also encourage the progress of NSOM by reducing HDL cholesterol/apoA1. Resistin may be a potential risk factor for NSOM, whereas NGF may be a potential protective factor.

The Differences in HDL Levels in Workers at Kupang El-Tari Airport Based on BMI Normal and Obese

Background: Body Mass index (BMI) is one of the measurements to determine a person's nutritional status. Nutritional status is often influenced by diet, physical activity, and health status. IMT results can affect High Density Lipoprotein (HDL) levels in the body which if excessive or obese will cause dyslipidemia events characterized by decreased HDL levels. Objective: Knowing the difference in HDL levels in El-Tari Kupang Airport Workers Based on Normal BMI and Obesity. Methods: Observational analytic study using Cross Sectional design conducted on ElTari Kupang Airport workers. BMI was obtained from height and weight measurements, HDL levels were obtained through blood collection tested using Biochemistry Analyzer (BA-200) at the Laboratory of RSUD S.K Lerik Kupang, and protein frequency was obtained through Food Frequency Questionnaire (FFQ) conducted on 88 research samples that have met the inclusion criteria. Sampling using purposive sampling technique. The results of univariate and bivariate data analysis using the Mann-Whitney test. Results: The prevalence of normal BMI and obesity is 50% of people in each BMI category. HDL levels were highest in the borderline group (68.18%) then the normal group (20.46%) and the low group (11.36%). The frequency of animal and vegetable protein consumption was found to be below average. The results of bivariate analysis using Mann-Whitney showed a p value = 0.001 (p &lt; 0.05). Conclusion: There is a significant difference between High Density Lipoprotein (HDL) levels in workers at El-tari Airport Kupang based on normal and obese Body Mass Index (BMI).

The relationship between depression and lipid accumulation product: a population-based study.

Lipid Accumulation Product (LAP) is a new type of obesity index. The relationship between LAP and depression is unclear, and this cross-sectional study was conducted to explore the relationship between LAP and depression using the National Health and Nutrition Examination Survey (NHANES) database from 2005-2018. In our study, logistic regression analysis was used to calculate the odds ratio between depression and LAP, and subgroup analysis and sensitivity analysis were also performed to verify the robustness of the results. The analysis included 13,240 participants aged 20 years or older. After adjusting for multiple variables, LAP was positively associated with depression, OR 1. 50 (95% CI, 1. 05-2. 12). In subgroup analysis, LAP was significantly positively, associated with depression among male (2. 52, OR; 95% CI, 1. 39,4. 57), non-Hispanic Black (2. 55, OR; 95% CI, 1. 49,4. 36), those without diabetes (1. 67, OR; 95% CI, (1. 06,2. 61) or in the overweight (2. 09, OR; 95% CI, (1. 23,3. 54) subgroups. After inverse probability of treatment weighting (IPTW), the OR for the highest versus lowest quartile was 1. 55 (95% CI: 1. 24 - 1. 95). There are positive results between LAP and depression after adjusting for multiple potential variables, and prospective studies are needed to verify the results.

Method of Diagnosing Sarcopenia in Morbidly Obese Patients

Introduction. Sarcopenia refers to a clinical syndrome characterized by progressive skeletal muscle disease, loss of muscle mass and strength resulting in impaired physical performance. The prevalence of sarcopenia in the population ranges from 5% to 13% in people aged 43.0 ± 11.1 years and reaches 50% in those over 70. Various methods have been used to diagnose sarcopenia, which, however, have their limitations. Currently, CT scanning is considered the most accurate method for the detection of sarcopenia. Therefore, the development of new methods for early diagnosis of sarcopenia appears relevant. Aim. To investigate different methods of diagnosing sarcopenia in morbidly obese patients. Materials and methods. The study presents an analysis of various methods for diagnostics of sarcopenia in morbidly obese patients, including a patented method based on the research conducted in the BSMU Clinic (Utility Patent No. 2815157 dated 11.03.2024). Results and discussion. Doctors used the suggested method of diagnosis, defined the value of sarcopenia index equal or less than 15, and diagnosed sarcopenia. Conclusion. The prevalence and severity of sarcopenia vary depending on the classification criteria and thresholds used. Since a unified diagnostic method is yet to be developed, it is necessary to continue research into this issue, and introduce sarcopenia detection, prevention, and correction techniques into widespread clinical practice. Indices of sarcopenia and obesity, obtained during an additional preoperative study, provide significant prognostic information superior to body mass index, thereby enabling the direction and scope of surgical interventions to be determined and survival outcomes to be improved.

Associations between different triglyceride glucose index-related obesity indices and periodontitis: results from NHANES 2009–2014

BackgroundThis study aimed to explore the associations between triglyceride glucose (TyG) index-related obesity indices and periodontitis within the American population.MethodsThis cross-sectional investigation utilized data from the National Health and Nutrition Examination Survey (NHANES) for 2009–2014. The association between the TyG–waist-to-height ratio (TyG-WHtR), TyG–weight-adjusted-waist index (TyG-WWI), TyG–waist circumference (TyG-WC), or TyG–body mass index (TyG-BMI) and periodontitis was investigated utilizing multivariable logistic regression model, subgroup, and dose-response curve analyses.ResultsThis study enrolled 4,808 adult participants. Except for TyG-BMI, which did not exhibit a relationship with periodontitis, TyG-WHtR, [odds ratio (OR) (95% confidence interval (CI))] = 2.83 [1.58–5.10], P = 0.002], TyG-WWI [OR (95% CI) = 7.50 (3.06–18.34), P < 0.001], and TyG-WC [OR (95% CI) = 2.12 (1.23–3.64), P = 0.011] were all associated with periodontitis. Participants in the highest quartile displayed an elevated risk of periodontitis relative to their counterparts in the lowest quartile, as evidenced for TyG-WWI [OR (95% CI) = 1.72 (1.26–2.33), P = 0.001] and TyG-WC [OR (95% CI) = 1.50 (1.13–1.99), P = 0.009] in the full adjustment model. Subgroup analyses suggested more pronounced positive associations between these indices and periodontitis in participants who were < 60 years old, had a BMI ≥ 25, and did not have diabetes. The dose-response curve indicated linear responses in these associations.ConclusionsThis investigation identified a significant and stable association between TyG-WHtR, TyG-WWI, or TyG-WC and periodontitis, which implies a robust correlation between high insulin resistance and susceptibility to periodontitis in the American population.

Longitudinal associations of social jetlag with obesity indicators among adolescents - Shanghai adolescent cohort

ObjectiveTo explore the longitudinal association between social-jetlag (SJL) and obesity development among adolescents, sex-difference and related modifying factors in the association. MethodsBased on Shanghai-Adolescent-Cohort during 2017–2021, a total of 609 students were investigated. In grade 6, 7 and 9, the information on SJL was collected using questionnaires, and anthropometric measures were conducted. The fingernail cortisol and progesterone levels in grade 6 (using LC-MS/MS) and body composition in grade 9 (using Inbody-S10) were measured. By the latent-class-mixture-modeling, two trajectories for SJL (high-level vs. low-level) throughout 4 years were developed. The prospective associations of SJL trajectories and weight/fat gains were analyzed by sex and under different (high/moderate/low) cortisol/progesterone stratifications. ResultsIn grades 6–9, 39.00%–44.50 % of adolescents experienced at least 1 h of SJL. Compared with the low-level SJL trajectory, the high-level SJL trajectory was associated with greater differences in body-mass-index Z-scores and waist-to-height ratios across 4 years, higher levels of body-fat-percentage and fat-mass-index in grade 9 (P-values<0.05), and such associations were stronger among girls and under moderate-to-high (vs. low) baseline cortisol and progesterone levels. However, no significant associations among boys were observed. ConclusionsHigh-level SJL in adolescents may be associated with the development of obesity, especially among adolescent girls and under relatively high baseline cortisol and progesterone levels.

Associations of body mass index, waist circumference and the weight-adjusted waist index with daily living ability impairment in older Chinese people: A cross-sectional study of the Chinese Longitudinal Healthy Longevity Survey.

To investigate the associations of body mass index (BMI), waist circumference (WC) and the weight-adjusted waist index (WWI) with the impairment of activities of daily living (ADL) in older Chinese people. A total of 13 260 participants aged 65 years and older from the 2018 Chinese Longitudinal Healthy Longevity Survey were included in this cross-sectional study. BMI, WC and the WWI were calculated from measurements of height, weight and WC. Binary logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). Non-linear correlations were investigated using restricted cubic spline curves. In multivariate logistic regression fully adjusted for confounding variables, our analyses revealed significant associations between WC and WWI and ADL impairment, with adjusted ORs (95% CI) of 1.01 (1.00, 1.01) and 1.08 (1.03, 1.12), respectively. Meanwhile, participants with a high WWI had a higher risk of ADL impairment compared with those with a low WWI, with an adjusted OR (95% CI) of 1.12 (1.02, 1.23). Subgroup analyses showed that only the association between WWI and ADL impairment did not differ in any of the different populations. In addition, we found that BMI, WC and WWI were non-linearly associated with ADL impairment. There are significant associations between WC and WWI and ADL impairment in older Chinese people. The findings show the ability of the WWI to serve as a comprehensive and effective indicator of obesity in older Chinese people and emphasize the importance of assessing WWI in screening and preventing ADL impairment in older people.

Triglyceride glucose-related indexes and lipid accumulation products-reliable markers of insulin resistance in the Chinese population.

Insulin resistance (IR) is a pivotal pathogenic component of metabolic diseases. It is crucial to identify convenient and reliable indicators of insulin resistance for its early detection. This study aimed at assessing the predictive ability of seven novel obesity and lipid-related indices. A total of 5,847 female and 3,532 male healthy subjects were included in the study. The triglyceride glucose (TyG) index, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), lipid accumulation products (LAP), body roundness index (BRI), body adiposity index (BAI), and visceral adiposity index (VAI) were measured and calculated using the established formulae. IR was diagnosed using the homeostatic model assessment of insulin resistance (HOMA-IR) index over the third quantile. The levels of all seven lipid-related indices were significantly higher in subjects with higher HOMA-IR values than in those with lower HOMA-IR values. These indices displayed moderate to high effectiveness [receiver operating characteristic (ROC) curve-area under the curve (AUC) > 0.6] in predicting IR. Among them, TyG-BMI (AUC: 0.729), LAP (AUC: 0.708), and TyG-WC (AUC: 0.698) showed the strongest association with HOMA-IR. In the female population, the AUC for TyG-BMI, LAP, and TyG-WC in predicting IR was 0.732, 0.705, and 0.718, respectively. Logistic regression analysis showed the optimal cut-off values of those indicators in predicting IR as follows: TyG-BMI: male subjects - 115.16 [odds ratio (OR) = 6.05, 95% CI: 5.09-7.19], female subjects - 101.58 (OR = 4.55, 95% CI: 4.00-5.16); LAP: male subjects - 25.99 (OR = 4.53, 95% CI: 3.82-5.38), female subjects - 16.11 (OR = 3.65, 95% CI: 3.22-4.14); and TyG-WC: male subjects - 409.43 (OR = 5.23, 95% CI: 4.48-6.24), female subjects - 342.48 (OR = 4.07, 95% CI: 3.59-4.61). TyG-index-related parameters and LAP appear to be effective predictors of IR in the Chinese population. Specifically, TyG-BMI may be the most appropriate predictor of IR.

Sonographic Evaluation of Visceral Fat and its Correlation with Metabolic and Liver Profiles in Obese Children

Abstract Background Abdominal obesity plays a major role in development of metabolic syndrome. Computed tomography and dual-energy X-ray absorptiometry were used to assess abdominal fat in children but carry risk of radiation and are expensive. Assessing abdominal fat using ultrasound in obese children could be a reasonable alternative with evaluating its relationship to obesity indicators especially insulin resistance. Methods We conducted a cross sectional study on 46 obese children and adolescents aged between 6-16 years to evaluate abdominal adiposity by using ultrasound. Subcutaneous fat thickness (SFT) and visceral fat thickness (VFT) were measured and correlated to anthropometric measures, fasting lipid profile, HOMA-IR and liver function tests. Results VFT was strongly correlated with the BMI (r = 0.397, p=0.006) and HOMA- IR (r = 0.413, P = 0.004) with AUC for VFT as a predictor of insulin resistance of 0.858 and cut of point of &amp;gt; 2.98 cm . VFT also correlated positively with serum triglycerides (r = 0.421, p=0.004) and serum ALT (r = 0.370, P=0.011). VFT correlated negatively with HDL (r= -0.313, P= 0.034 ). Conclusions Ultrasound could be a useful tool for measuring abdominal fat thickness in children and adolescents. Ultrasound measured VFT could be an appropriate prognostic factor for insulin resistance, hypertriglyceridemia, and elevated liver enzymes.

Study of Body Composition by Biphotonic X-ray Absorptiometry in a Moroccan Female Population, an Indicator of Obesity?

Our purpose was to study the body composition in a healthy female Moroccan adult group, and to help physicians to evaluate nutritional status. Five hundred and nineteen healthy women aged from 20 to 80 years were included in the study. Bone mineral density at the hip and lumbar spine and the body composition parameters were measured by dual-energy X-ray absorptiometry: fat mass (FM), fat-free mass (FFM), and percentage (%) of body fat. The FFM index (FFMI) and the FM index (FMI) were calculated. We analyzed the population by age and body mass index (BMI) defined groups. The mean age of the population was 53.14 ± 13.69 years with an average BMI of 29.30 ± 5.04 kg/m2. Means of FM and FFM were 33.93 ± 9.18 kg and 36.91 ± 5 kg, respectively, with FM and FFMI of 13.65 ± 3.66 kg/m2 and 14.85 ± 1.91 kg/m2, respectively. The % FM, FFM, and their corresponding indices increased with age; a statistically significant difference was observed between the 20 and 39 age categories and the two other categories. The BMI category analysis showed that FFMI and FMI increased in obese women with a statistically significant difference between the four groups. Age and BMI were correlated significantly with the different parameters. This is the first Moroccan study to present body composition indexes in healthy Moroccan female adults. These reference values may be useful for the clinical evaluation of body composition and nutritional status.

Linear associations of Chinese visceral adiposity index and its change with hyperuricemia: A prospective cohort study

Background and aimsThis study aims to investigate the association of Chinese visceral adiposity index (CVAI) with incident hyperuricemia (HUA). Methods and resultsWe included 5186 adults aged ≥45 years from China Health and Retirement Longitudinal Study. Modified Poisson regression model was used to estimate the relative risks (RRs) of incident HUA associated with baseline CVAI, and logistic model was used to estimate the odds ratios (ORs) of HUA for CVAI change. Restricted cubic splines analysis was adopted to model the dose–response associations. The area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the predictive value of CVAI. During 4-year follow-up, a total of 510 (9.8%) HUA cases were identified. The RRs (95%CIs) of incident HUA were 3.75 (2.85–4.93) for quartile 4 versus quartile 1 and 1.56 (1.45–1.69) for per-standard deviation increase in baseline CVAI. For the analyses of CVAI change, compared with stable group, participants in decreased group had 34% lower risk (OR 0.66, 95%CI 0.49–0.87) and those in increased group had 35% (1.35, 1.03–1.78) higher risk of HUA. Linear associations of baseline CVAI and its change with HUA were observed (Pnonlinear >0.05). Besides, the AUC value for HUA was 0.654 (0.629–0.679), which was higher than other five obesity indices. ConclusionsOur study found linear associations between baseline CVAI and its change and risk of HUA. CVAI had the best predictive performance in predicting incident HUA. These findings suggest CVAI as a reliable obesity index to identify individuals with higher HUA risk.

Regional fat distribution and hepatic fibrosis and steatosis severity in patients with nonalcoholic fatty liver disease and type 2 diabetes.

Epidemiologic findings suggest that measures of body fat distribution predict health outcomes independent of the overall body fat assessed by body mass index (BMI). This study aimed to evaluate the associations of overall and regional body fat with the severity of hepatic steatosis and fibrosis in type 2 diabetic patients with non-alcoholic fatty liver disease. Bioelectric impedance analysis and two newly developed anthropometric indices, namely, A Body Shape Index (ABSI) and Body Roundness Index (BRI), were used to estimate the body fat. Based on fibroscan parameters, significant hepatic fibrosis and severe steatosis were defined as ≥F2 and >66%, respectively. Higher total body fat (odds ratio [OR] 1.107, 95% confidence intervals (CI) 1.038-1.182, p=0.002), trunk fat (OR 1.136, 95% CI 1.034-1.248, p=0.008) and leg fat (OR 1.381, 95% CI 1.139-1.674, p=0.001) were associated with liver fibrosis. However, in contrast to the total body fat (OR 1.088, 95% CI 1.017-1.164, p=0.014) and leg fat (OR 1.317, 95% CI 1.066-1.628, p=0.011), the trunk fat was not associated with severe hepatic steatosis. BRI performed better than trunk, leg and total body fat in predicting hepatic steatosis (OR 2.186, 95% CI 1.370-3.487, p=0.001) and fibrosis (OR 2.132, 95% CI 1.419-3.204, p<0.001). Moreover, the trunk to leg fat ratio and ABSI were not independent predictors of either steatosis or fibrosis (p>0.05). BRI revealed a superior predictive ability for identifying the degree of hepatic steatosis and stiffness than other obesity indices. Additionally, higher levels of adiposity in the trunk, legs, and overall body were linked to an increased risk of developing liver fibrosis. Although trunk fat did not show an association with severe hepatic steatosis, an increase in leg and total fat was related to liver steatosis.

Targeted Obesity Genes Single Nucleotide Polymorphisms, Diet, Lifestyles, and Obesity Indices: Nutrigenetics as a Predictive Model

Targeted Obesity Genes Single Nucleotide Polymorphisms, Diet, Lifestyles, and Obesity Indices: Nutrigenetics as a Predictive Model

Poster 149: Supplemental Testosterone Increases Risk of Reoperation after Total Shoulder Arthroplasty

Objectives: Periprosthetic joint infections (PJIs) are devastating complications after total shoulder arthroplasty (TSA). While it has been shown that increased serum testosterone levels may increase the concentration of skin flora, it is unknown how this correlates clinically with the risk of infection/reoperation. Therefore, we sought to evaluate if supplemental testosterone increases the risk of infection and reoperation after TSA. Methods: We retrospectively reviewed 448 males who underwent TSA between January 1, 2017 and December 31, 2021 who were prescribed supplemental testosterone within 1 year prior to TSA using a commercial claims database. These patients were matched 1:5 to 2240 patients who were not prescribed supplemental testosterone based on year of TSA, age, geographical region, inpatient or outpatient TSA, and comorbidities within 30 days preoperatively including hypertension, hyperlipidemia, diabetes, obesity, smoking, alcohol abuse, and Charleson Comorbidity Index (CCI) using Mahalanobis nearest neighbor matching. Univariable and multivariable analyses were performed. Significance was set at p &lt; 0.05. Results: Patients prescribed supplemental testosterone were younger (mean = 60.5 versus 61.3 years old, p = 0.04), but otherwise demographics were similar between cohorts (Table 1). Mean follow-up was 1.5 years. At 2 years postoperatively, patients prescribed testosterone had a higher cumulative incidence for reoperation for infection at 2.0% compared to 0.9% for those who were not prescribed testosterone (p = 0.04). Multivariable analysis demonstrated that preoperative supplemental testosterone (OR = 2.6, 95% CI = 1.03-6.6, p=0.04), diabetes (OR = 2.9, 95% CI = 1.1-7.9, p=0.04), and alcohol abuse (OR = 11.4, 95% CI=2.2-60.1, p = 0.004) were risk factors for reoperation for infection (Table 2). At 2 years postoperatively, patients prescribed testosterone had a higher cumulative incidence for overall reoperation at 9.6% compared to 4.0% for those who were not prescribed testosterone (p &lt; 0.001). Multivariable analysis showed that supplemental testosterone was found to be risk factor for overall reoperation (OR = 2.1, 95% CI = 1.3-3.2, p = 0.001) (Table 3). Conclusions: Patients prescribed supplemental testosterone had a higher risk of all cause reoperation and reoperation for infection after TSA. Further research is needed to understand the mechanism by how testosterone increases the risk of reoperation after TSA.

Obesity Indices Positively Correlate With Age in 2 to 5-Year-Old Children in a Head Start Program and Was Exacerbated by the Coronavirus Disease 2019 Pandemic

Obesity Indices Positively Correlate With Age in 2 to 5-Year-Old Children in a Head Start Program and Was Exacerbated by the Coronavirus Disease 2019 Pandemic