Optimal Body Mass Index Research Articles

Modifiable Behaviors Help to Explain the Inequalities in Perceived Health Associated With Deprivation and Social Class: Evidence From a National Sample

The association between health and deprivation is of serious concern to many health promotion agencies. The purpose of the current study was to assess whether modifiable behaviors of physical activity (PA), sports participation, diet, smoking and body mass index (BMI) can help to explain these inequalities in a sample of 4653 respondents from Northern Ireland. The study is based on a cross-sectional survey of Northern Irish adults. Responses to a self-rated health question were dichotomized and binary logistic regression was used to identify the health inequalities between areas of high, middle or low deprivation. These differences were further adjusted for other sociodemographic factors and subsequently for various modifiable behaviors of PA, sports participation, diet, smoking, and BMI. Respondents from high and middle areas of deprivation are more likely to report poorer health. As soon as sociodemographic factors and other modifiable behaviors were included, these inequalities either disappeared or were greatly reduced. Many inequalities in health in NI can be explained by the respondents' sociodemographic characteristics that can be further explained by introducing information about respondents who meet the recommended PA guidelines, play sport, eat 5 portions of fruit and vegetables, and maintain an optimal BMI.

Appropriate anthropometric indices to identify cardiometabolic risk in South Asians.

South Asians show an elevated cardiometabolic risk compared to Caucasians. They are clinically metabolically obese but are considered normal weight based on current international cut-off levels of several anthropometric indices. This study has two main objectives: (i) to predict the most sensitive anthropometric measures for commonly studied cardiometabolic risk factors, and (ii) to determine optimal cut-off levels of each of the anthropometric indices in relation to these cardiometabolic risk factors in South Asians. The study was conducted on a random sample of 1178 adults of 20-80 years of age from an urban population of eastern India. Obesity, as evaluated by standard anthropometric indices of BMI (body mass index), WC (waist circumference), WHpR (waist-to-hip ratio) and WHtR (waist-to-height ratio), was individually correlated with cardiometabolic risk factors. Receiver operating characteristic (ROC) curve analyses were performed which includes: (i) the area under the receiver operating characteristic curve (AUROC) analysis to assess the predictive validity of each cardiometabolic risk factor; and (ii) Youden index to determine optimal cut-off levels of each of the anthropometric indices. Overall, AUROC values for WHtR were the highest, but showed variations within the sexes for each of the cardiometabolic risk factors studied. Further, WHpR cut-offs were higher for men (0.93-0.95) than women (0.85-0.88). WC cut-offs were 84.5-89.5 cm in men and 77.5-82.0 cm in women. For both sexes the optimal WHtR cut-off value was 0.51-0.55. The optimal BMI cut-offs were 23.4-24.2 kg/m2 in men and 23.6-25.3 kg/m2 in women. WHtR may be a better anthropometric marker of cardiometabolic risks in South Asian adults than BMI, WC or WHpR.

Abstract P2-11-12: Proactive approach to risk reduction and early detection of breast cancer related lymphedema

Abstract Advances in surgery and post-operative treatment continue to reduce the incidence of late effects of cancer treatment such as lymphedema. Yet, many breast cancer survivors still face considerable post-operative challenges as a result of developing lymphedema. The purpose of this study was to preliminarily evaluate a nursing educational and behavioral program “The Optimal YOU” to enhance lymphedema risk reduction, focusing on preventing inflammation-infection, promoting lymph drainage, and maintaining optimal Body Mass Index (BMI) as well as preoperative and subsequent follow-up assessment of limb volume changes and symptoms. A quasi-experimental design with repeated-measures was used. The Study outcomes included lymph volume changes by infra-red perometer, lymphedema-related symptoms, and BMI by Bioimpedance at pre-operative baseline, post-operative, 6-month, and 12-month follow-up. A total of 147 patients were recruited and received the program, 141 patients completed the study (4% attrition rate). Majority (over 90%) of patients maintained preoperative limb volume and improved their symptom experience at 12-month follow-up. During the study period, only 7 patients (5%) had measurable lymphedema. At 12-month follow-up, among the 7 patients who developed measurable lymphedema, 2 patients' limb volume returned to pre-operative level without compression therapy only by maintaining exercises of The Optimal YOU to promote daily lymph flow. About 80% of patients maintained or improved their preoperative BMI. Implementation of this nursing educational and behavioral intervention is effective to enhance lymphedema risk reduction and early detection. Findings of the study provided evidence to support the emerging policy change in lymphedema care, shifting treatment-focus care to proactive risk reduction. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-11-12.

BMI percentiles for the identification of abdominal obesity and metabolic risk in children and adolescents: evidence in support of the CDC 95th percentile

ObjectivesBMI percentiles have been routinely and historically used to identify elevated adiposity. This paper aimed to investigate the optimal Centers for Disease Control and Prevention (CDC) body mass index (BMI) percentile that predicts elevated visceral adipose tissue (VAT), fat mass and cardiometabolic risk in a biracial sample of children and adolescents.Participants and MethodsThis cross-sectional analysis included 369 white and African American children (5–18 y). BMI was calculated using height and weight and converted to BMI percentiles based on CDC growth charts. Receiver operating characteristic curve analysis identified the optimal (balance of sensitivity and specificity) BMI percentile to predict the upper quartile of age-adjusted VAT (measured by magnetic resonance imaging), age-adjusted fat mass (measured by dual energy x-ray absorptiometry) and elevated cardiometabolic risk (≥ 2 of high glucose, triglycerides and blood pressure and low high density lipoprotein cholesterol) for each race-by-sex group.ResultsThe optimal CDC BMI percentile to predict those in the top quartile of age-adjusted VAT, age-adjusted fat mass and elevated cardiometabolic risk were the 96th, the 96th and the 94th percentiles, respectively, for the sample as a whole. Sensitivity and specificity was satisfactory (> 0.70) for VAT and fat mass. Compared to age-adjusted VAT and age-adjusted fat mass, there was a lower overall accuracy of the optimal percentile in identifying those with elevated cardiometabolic risk.ConclusionsThe present findings support the utility of the 95th CDC BMI percentile as a useful threshold for the prediction of elevated levels of VAT, fat mass and cardiometabolic risk in children and adolescents.The study is registered at clinicaltrials.gov as NCT01595100.

The obesity paradox – A reality that requires explanation and clinical interpretation

Obesity is a chronic relapsing disease that is clearly associated with increased risk of developing type 2 diabetes, cardiovascular disease, and many cancers leading to reduced life expectance [1,2]. Prevention of obesity and its associated comorbidity is a global health priority [3,4]. There is now clear evidence that, under a range of human conditions, there are hard clinical and mortality advantages of a body mass index (BMI) above that considered normal or ideal for the general population. The association between BMI and mortality is usually U-shaped with increasing risk at both low and high ends of the continuum, but the nadir or optimal BMI for lowest mortality varies with age, ethnicity and a the presence of established disease.

Determining the optimal cutoff points for waist circumference and body mass index for identification of metabolic abnormalities and metabolic syndrome in urban Thai population

This study describes the prevalence and optimal waist circumference (WC) and body mass index (BMI) cutoff point for metabolic abnormalities and metabolic syndrome (MS) from urban Thai population. The optimal BMI/WC cutoff has been used for identifying and evaluating metabolic abnormalities for screening individuals having risk factor of MS.

Proactive approach to risk reduction and early detection of breast cancer-related lymphedema.

95 Background: Advances in surgery and post-operative treatment continue to reduce the incidence of late effects of cancer treatment such as lymphedema. Yet, many breast cancer survivors still face considerable post-operative challenges as a result of developing lymphedema. The purpose of this study was to preliminarily evaluate an educational and behavioral program “The Optimal YOU” to enhance lymphedema risk reduction among patients with breast cancer. The intervention focuses on preventing inflammation-infection, promoting lymph drainage, and maintaining optimal BMI as well as preoperative and subsequent follow-up assessment of limb volume changes and symptoms. Methods: A quasi-experimental design with repeated-measures was used to assess outcomes of The Optimal YOU program at pre-operative baseline, post-operative, 6-month, and 12-month follow-up. A total of 147 patients newly diagnosed with breast cancer were recruited and received the program. The program outcome data include lymph volume changes by infra-red perometer-S350, lymphedema-related symptoms by Lymphedema Symptom Experience Index, and body mass index (BMI) by Bioimpedance DF50. Results: Among the 147 patients, 141 patients completed the study (4% attrition rate). Majority (94%) of patients maintained preoperative limb volume and improved their symptom experience at 12-month follow-up. During the 12-month study period, only five patients (6%) developed lymphedema and were referred for lymphedema treatment. At 12-month follow-up, among the five patients who developed measurable lymphedema, two patients’ limb volume returned to pre-operative level without compression therapy only by maintaining exercises of The Optimal YOU to promote daily lymph flow. About 80% of patients maintained or improved their preoperative BMI. Conclusions: The study shows that proactive approach to implementing The Optimal YOU program is effective to risk reduction and early detection of breast cancer-related lymphedema by focusing on preventing inflammation-infection, promoting lymph drainage, and maintaining optimal BMI.

Appropriate BMI cut-off values for identification of metabolic risk factors: Third national surveillance of risk factors of non-communicable diseases in Iran (SuRFNCD-2007)

Aim: To determine the appropriate threshold of body mass index (BMI) associated with increased risk of cardiovascular diseases in a large representative sample of an Iranian population.Subjects and methods: Data of third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007) were used in this study. Sensitivity, specificity, and shortest distance on the receiver-operating characteristic (ROC) curves were used to determine gender-specific optimal cut-offs of BMI for cardiometabolic risk factors including elevated blood pressure, low high-density lipoprotein cholesterol, high triglycerides, high fasting plasma glucose and for ≥ 2 of the aforementioned risk factors.Results: There was a continuous increase in the prevalence of cardiometabolic risk factors with increasing BMI (p < 0.001). At the BMI of 25–29 kg/m2 men were at higher risk of cardiovascular diseases compared to women (p < 0.001). The appropriate BMI cut-offs ranged from 24.6–26.1 kg/m2 for men and from 26.9–28.8 kg/m2 for women. The optimal BMI cut-offs for identifying any two or more of those risk factors were 25.2 and 27.3 kg/m2 in men and women, respectively.Conclusion: In men the appropriate BMI cut-offs are ∼25 kg/m2, while in women higher BMI values are associated with risk of cardiovascular diseases.

Underweight and overweight men have greater exercise-induced dyspnoea than normal weight men

Introduction. Persons with high or low body mass index (BMI), involved in clinical or mechanistic trials involving exercise testing, might estimate dyspnoea differently from persons with a normal BMI.Aims. Our objective was to investigate the relationship between BMI and dyspnoea during exercise in normal subjects with varying BMI.Material and methods. A total of 37 subjects undertook progressive exercise testing. Subjects were divided into three groups: underweight (UW), normal weight (NW), and overweight (OW). Dyspnoea was estimated using the visual analogue scale (VAS). Spirometry, maximum voluntary ventilation (MVV), and respiratory muscle strength (RMS) were measured.Results and discussion. The intercept of the VAS/ventilation relationship was significantly higher in NW subjects compared to UW (P = 0.029) and OW subjects (P = 0.040). Relative to the OW group, FVC (P = 0.020), FEV1 (P = 0.024), MVV (P = 0.019), and RMS (P = 0.003) were significantly decreased in the UW group. The greater levels of dyspnoea in UW subjects could possibly be due to decreased RMS. Healthy persons should aim to achieve an optimum BMI range to have the lowest exercise-induced dyspnoea.

When a reference value makes all the difference

Dear Editor, I read with great interest the article by Webber and Barr on the age- and gender-dependent values of skeletal muscle mass in healthy children and adolescents 1. The authors open a field of scientific dispute that is often underrepresented if not totally neglected. The validity of any method of measurement depends not only on the appropriate choice of a certain method according to the question to be studied. In fact, the interpretation of the results depends just as much on the existence of adequate standards and reference values to which our measurements can be compared. Age and gender are fundamental factors influencing probably all biological measurements and should be taken into account for correct interpretation of clinical data. Webber and Barr provide reference values for normal ranges of skeletal muscle tissue mass in children and adolescents separately for females and males. Moreover, they confirm the high reproducibility of dual X-ray absorptiometry (DXA) to detect differences in muscle tissue mass as low as a few hundred grams. For this rather sophisticated method of assessing body composition, interpretation according to age and gender seems well appreciated. By contrast, it is surprising that the most global measure of body composition, namely body mass index (BMI), is commonly applied to patients and populations irrespective of age. There is increasing evidence that in older populations the association of body composition with mortality is substantially shifted as compared to middle-aged populations 2–4. According to the World Health Organisation, the “optimum BMI” ranges from 18.5 to 25 kg/m2. It may be another point of discussion what the “optimum” refers to and whether these margins are still applicable, as the nadir of the mortality curves in recent epidemiological observations is around or even above 25 kg/m2 4. The discussion on the accuracy of BMI as a predictor of disease and/or mortality is ongoing 5. Clearly, the simplicity of the method may be weighed against the limitations of the data obtained. A first step would be to address different age groups for reference values of BMI, just as presented by Webber and Barr for DXA. The author of this manuscript certifies that he complied with the ethical guidelines for authorship and publishing in the Journal of Cachexia, Sarcopenia and Muscle 6.

Does Running Cause Osteoarthritis in the Hip or Knee?

Running is an excellent activity to promote general health and well-being. However, running injuries are common, and concern is sometimes raised that running might lead to osteoarthritis in weight-bearing joints. This article reviews the relevant in vitro and in vivo literature that looks at possible associations between running and the development of osteoarthritis. Also reviewed is the limited literature on running barefoot and with minimalist footwear. Low- and moderate-volume runners appear to have no more risk of developing osteoarthritis than nonrunners. The existing literature is inconclusive about a possible association between high-volume running and the development of osteoarthritis. The early literature on running barefoot and running with minimalist footwear has primarily focused on biomechanics but has not yet focused on any effect on cartilage health. Experienced and beginner runners should be encouraged to allow the body adequate time to adapt to changes in gait biomechanics caused by changing footwear, which can be done by slowly increasing running mileage in the new footwear. Clinicians can improve the health of runners by encouraging appropriate treatment of musculoskeletal injuries, encouraging maintenance of an optimal body mass index, and correcting gait abnormalities caused by deficits in flexibility, strength, or motor control along the kinetic chain.

Prospective study of optimal obesity index cutoffs for predicting development of multiple metabolic risk factors: the Korean genome and epidemiology study.

BackgroundIn this prospective cohort study, we estimated the risk of developing more than 1 metabolic risk factor, using different obesity indices. In addition, we investigated the relative usefulness of the obesity indices for predicting development of such risk factors and calculated optimal cutoffs for the obesity indices.MethodsThe cohort comprised 10 038 representative residents of a small city and a rural county who were recruited in 2001–2002. Follow-up examinations were conducted every 2 years. Among the 3857 participants without metabolic syndrome at baseline, 1102 new cases occurred during the 6-year follow-up. Receiver operating characteristic (ROC) curves for the obesity indices were plotted to compare the usefulness of the obesity indices.ResultsThe numbers of new cases of multiple metabolic risk factors among people in the highest quintiles of body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and waist-height ratio at the baseline examination were 2 to 3 times those in the lowest quintiles. The area under the ROC curve for WHR was significantly higher than that for BMI. The optimal BMI cutoff was 24 kg/m2 in men and women, and the optimal WC cutoffs were 80 cm and 78 cm in men and women, respectively.ConclusionsBoth overall obesity and central obesity predicted risk of developing multiple metabolic risk factors, and WHR appeared to be a better discriminator than BMI. To prevent development of metabolic diseases among Koreans, it might be useful to lower the cutoff for abdominal obesity, as defined by WC.

BMI is strongly associated with hypertension, and waist circumference is strongly associated with type 2 diabetes and dyslipidemia, in northern Chinese adults.

BackgroundObesity is closely associated with chronic diseases such as hypertension, type 2 diabetes mellitus (T2DM), and dyslipidemia. We analyzed the optimal obesity index cut-off values for metabolic syndrome (MetS), and identified the obesity index that is more closely associated with these chronic diseases, in a population of northern Chinese.MethodsWe surveyed 8940 adults (age, 20–74 years) living in northern China for chronic diseases. Receiver operating characteristics (ROC) analysis, relative risk, and multivariate regression were used to develop an appropriate index and optimal cut-off values for MetS and obesity-related chronic diseases.ResultsWaist circumference (WC) and body mass index (BMI) were good markers for MetS, WC was a good marker for T2DM and dyslipidemia, and BMI was a good marker for hypertension. The optimal BMI cut-off value of MetS was 24 kg/m2, and the optimal WC cut-offs were 86 cm and 78 cm in men and women, respectively. Relative risk regression models showed that BMI was associated with hypertension, T2DM, and hypertriglyceridemia and a higher prevalence ratio (PR) for hypertension: 2.35 (95% CI, 2.18–2.50). WC was associated with T2DM, hypertension, and hypertriglyceridemia, with PRs of 2.05 (1.63–2.55) for T2DM and 2.47 (2.04–2.85) for hypertriglyceridemia. In multivariate regression models, the standardized regression coefficients (SRCs) of BMI were greater for SBP and DBP, and the SRC of WC was greater for fasting blood glucose, 2-hour postload blood glucose, triglyceride, and total cholesterol.ConclusionsOur analysis of a population of northern Chinese indicates that the optimal cut-off values for MetS are WCs of 86 cm in men and 78 cm in women and a BMI of 24 kg/m2 in both sexes. BMI was strongly associated with hypertension, while WC was strongly associated with T2DM and dyslipidemia.

An Optimal Body Mass Index Range Associated With Improved Immune Reconstitution Among HIV-Infected Adults Initiating Antiretroviral Therapy

Higher body mass index (BMI) was associated with slower human immunodeficiency virus (HIV) disease progression before the availability of effective antiretroviral therapy (ART), but the relationship between pretreatment BMI and CD4(+) lymphocyte recovery on ART is not well described. We conducted an observational cohort study of HIV-infected, ART-naive adults starting treatment at a clinic affiliated with Vanderbilt University in Nashville, Tennessee. We assessed the relationship between pretreatment BMI and CD4(+) lymphocyte count change from baseline to 12 months in all subjects, among those with plasma HIV-1 RNA levels <400 copies/mL for ≥ 6 months and those with <10% change in weight during follow-up. Linear regression models were adjusted for age, sex, race, protease inhibitor usage, year of ART initiation, and baseline CD4(+) lymphocyte count and HIV-1 RNA level. A total of 915 patients met inclusion criteria; 78% were male, and their median age, BMI, and CD4(+) lymphocyte count were 39 years, 24 kg/m², and 171 cells/μL, respectively. The CD4(+) lymphocyte increase at 12 months was greatest among patients with a pretreatment BMI of ~25-30 kg/m² and diminished above and below this range (P = .03). Similar patterns were observed in the subgroup analyses. Among patients with a pretreatment CD4(+) lymphocyte count < 200 cells/μL, a BMI of ~25 kg/m² was associated with the highest odds of reaching a CD4(+) lymphocyte count > 350 cells/μL at 12 months (P = .05). 12-month immune reconstitution on ART was highest among patients commonly classified as overweight, suggesting there may be an optimal BMI range for immune recovery on ART.

Sports, dietary habits, self-perception and BMI in a sample of young Italian athletes

The concept of health closely associates absence of disease and a state of overall well-being (physical, mental, social). This state can be achieved by a healthy dietary habit and by engagement in physical activity. Despite this, children and teenagers are increasingly becoming overweight and obese. The aim of this study was to evaluate whether different exercise habits, dietary habits and self perceptions could influence anthropometric characteristics, in particular the body mass index (BMI), in selected participants in high-level sport aged between 10 and 18 years. An anonymous questionnaire consisting of 20 multiple choice questions was submitted to 1,096 participants (757 males and 339 females) undergoing the preparticipation physical examination that is necessary before taking part in high-level sport in Italy. A descriptive analysis was developed based on relative frequencies because of the qualitative nature of most of the questions with the aim of determining the influence on BMI of: each type of sport; training hours; training hours and type of sport; individual diet (carbohydrates and proteins); habit with regard to breakfast; hours of training and diet; and psychological motivations for eating. Only the combined action of a proper dietary habit and an adequate number of training hours resulted in a radical shift towards an optimal BMI. Moreover, a “negative” psychological motivation for eating possibly influenced the distribution of BMI even in athletes who followed a correct dietary and training lifestyle.

What is the optimal body mass index for Chinese people?

See related research article by Lin and colleagues at [www.cmaj.ca/cgi/doi/10.1503/cmaj.100303][1]. In this issue, Lin and colleagues report the findings of their study of the association between body mass index (BMI) and all-cause mortality among Chinese adults aged 20 years or older.[1][2] Using

Body Mass Index and Mortality From All Causes and Major Causes in Japanese: Results of a Pooled Analysis of 7 Large-Scale Cohort Studies

BackgroundWe pooled data from 7 ongoing cohorts in Japan involving 353 422 adults (162 092 men and 191 330 women) to quantify the effect of body mass index (BMI) on total and cause-specific (cancer, heart disease, and cerebrovascular disease) mortality and identify optimal BMI ranges for middle-aged and elderly Japanese.MethodsDuring a mean follow-up of 12.5 years, 41 260 deaths occurred. The Cox proportional hazards model was used to estimate hazard ratios (HRs) for each BMI category, after controlling for age, area of residence, smoking, drinking, history of hypertension, diabetes, and physical activity in each study. A random-effects model was used to obtain summary measures.ResultsA reverse-J pattern was seen for all-cause and cancer mortality (elevated risk only for high BMI in women) and a U- or J-shaped association was seen for heart disease and cerebrovascular disease mortality. For total mortality, as compared with a BMI of 23 to 25, the HR was 1.78 for 14 to 19, 1.27 for 19 to 21, 1.11 for 21 to 23, and 1.36 for 30 to 40 in men, and 1.61 for 14 to 19, 1.17 for 19 to 21, 1.08 for 27 to 30, and 1.37 for 30 to 40 in women. High BMI (≥27) accounted for 0.9% and 1.5% of total mortality in men and women, respectively.ConclusionsThe lowest risk of total mortality and mortality from major causes of disease was observed for a BMI of 21 to 27 kg/m2 in middle-aged and elderly Japanese.

Effects of Body Mass Index (BMI), Dietary Intake and Serum Antioxidant Vitamin Concentration on Urinary 8-hydroxydeoxyguanosine and F&lt;sub&gt;2&lt;/sub&gt;-isoprostane Excretions

Objective: The objective of this study was to identify the optimal BMI and desirable dietary habits for reducing oxidative stress and thereby slowing aging and preventing chronic diseases. We examined the relationships between urinary 8-hydroxydeoxyguanosine (8-OHdG) and F2-isoprostane excretions with BMI, dietary intakes and serum antioxidant vitamin concentrations. Method: The subjects were 15 people undergoing an Anti-Aging checkup (average age 64.9 [42-79], average BMI 23.2[16.0-31.6]).Exclusion criteria included a history of cancer, cardiovascular disease, stroke, diabetes, and current smoking. The serum parameters examined were α-carotene, β-carotene, vitamin C and vitamin E, the urinary parameters were 8-OHdG and F2-isoprostane and the dietary intake parameters were energy, carbohydrate, fat, protein, α-carotene, β-carotene, vitamin C, vitamin E and fruit and vegetable. Results: The relationships between urinary 8-OHdG and F2-isoprostane excretions and BMI both followed a quadratic curve with the lowest levels at BMI 23 (8-OHdG: R²= 0.749, F2-isoprostane: R² = 0.519). Multiple linear regression analysis showed that important variation factors for urinary 8-OHdG excretion were BMI and carbohydrate/energy ratio (R²= 0.826). Important variation factors for urinary F2-isoprostane excretion were BMI and serum vitamin E concentration (R²=0.613). Conclusion: The relationships between urinary 8-OHdG and F2-isoprostane excretions and BMI both followed a U-shaped curve with the lowest levels at BMI 23.

Optimal cut-off levels of body mass index and waist circumference in relation to each component of metabolic syndrome (MetS) and the number of MetS component

Aims There is an ethnic difference of obesity index to diagnose metabolic syndrome. The authors explored the optimal cut-off levels for body mass index (BMI) and waist circumference (WC) in relation to each component of metabolic syndrome. Materials and methods Receiver operating characteristics (ROC) analysis was used to determine the optimal cut-off levels for each component of metabolic syndrome. This study included 4572 workers aged 42.5 ± 9.9 years. Results The optimal BMI cut-off values for diabetes mellitus, hypertension or dyslipidemia varied from 23.0 to 24.3 kg/m 2. As for WC, the optimal cut-off values varied from 83.0 to 83.7 cm. The optimal BMI cut-off values relating with one to three components of metabolic syndrome varied from 23.2 to 25.3 kg/m 2. As for WC, the optimal cut-off values varied from 83.0 to 85.0 cm. Pair-wise comparison of ROC curves showed that WC has an advantage in relation to metabolic syndrome and its components compared with BMI. By logistic regression analysis, odds ratios of obesity indices for hypertension, dyslipidemia or the number of metabolic component were all significantly increased. As for diabetes mellitus, odds ratios of BMI ≥25 and WC ≥85 significantly increased, respectively. Conclusions Japanese criteria of obesity in metabolic syndrome in man may be appropriate for diabetes mellitus. Ethnic difference in criteria of obesity in Asian metabolic syndrome exists, and mutual comparisons in the prevalence of metabolic syndrome have a difficulty to conduct.

Risk Factors for Deterioration of Renal Function After Donor Nephrectomy

Introduction There are few recent studies investigating increased risks for adverse effects leading to chronic kidney disease (CKD) among kidney donors. The aim of this study was to identify factors that protect renal function among actual live kidney donors. Materials and Methods We enrolled 68 individuals who had undergone donor nephrectomy in this study. We assessed donor age, body mass index (BMI), casual blood pressure, preoperative and 3-month follow-up serum creatinines, serum total cholesterol, and several other clinical parameters. The severity of arteriosclerosis in the arteriolar and interlobular arteries of the donor kidney was semiquantitatively evaluated in 4 grades using back table biopsies. Impairment of renal function after surgery was expressed by differences in serum creatinine levels. Results The ratio of glomerular sclerosis, systolic blood pressure, and diastolic blood pressure positively correlated with donor age. Deterioration of renal function after donor nephrectomy negatively correlated with BMI and positively correlated with severity of arteriosclerosis in interlobular arteries. A multiple regression analysis model with respect to the severity of arteriosclerosis in interlobular arteries showed significant influence, of serum creatinine and systolic blood pressure. Conclusions Preventing progression of arteriosclerosis and selecting the optimal BMI before donor nephrectomy will help to avoid impaired renal function among live kidney donors.