Presence Of Abdominal Obesity Research Articles

#205 Features of chronic kidney disease in patients with obesity and arterial hypertension

Abstract Background and Aims to assess the indicators of composite body composition in patients with obesity and chronic kidney disease with arterial hypertension. Method 59 patients with obesity and arterial hypertension were examined. When selecting patients, inclusion criteria were taken into account: men and women aged 25 to 55 years, obesity (BMI more than 30 kg/m²; waist circumference (WC) more than 80 cm in women and more than 94 cm in men), presence of hypertension I– Stage II, grade 1–2, absence of renal pathology (history of kidney disease, structural changes in the parenchyma and vessels of the kidneys during ultrasound examination, changes in urinary sediment and urine density, proteinuria, decreased GFR less than 60 ml/min/1.73 m² ), signed informed consent. Metabolically complicated obesity was defined as the presence of abdominal obesity, a BMI of more than 30 kg/m2 in combination with hypertension and ≥ 2 cardiometabolic abnormalities. A metabolically healthy obesity phenotype was considered to be the presence of obesity without hypertension, dyslipidemia, or hyperglycemia. The results obtained during the study were compared with the indicators of a control group formed from 30 practically healthy individuals aged 25–55 years without obesity or overweight. Differences in age, gender, duration of hypertension and obesity were not established. Metabolic activity of adipose tissue was assessed by the level of leptin, soluble leptin receptors (sLR), adiponectin, resistin, free leptin index (FLI), leptin/adiponectin index (L/A). Renal function: GFR (CKD EPI and Hoek), serum and urine cystatin C, albuminuria. The composite composition of the body was studied using bioimpedance analysis using an ABC-01 Medass analyzer of body composition and balance of water sectors of the body. Results In a comparative analysis of the parameters of the composite body composition in the obese groups, the highest values ​​of fat mass (42.8 ± 6.8 and 35 ± 4.2 kg) and total fluid (40.2 ± 5.0 and 36.0 ± 2.8 kg) with a reduced proportion of 17 active cell mass (ACM) (53.0 ± 3.2 and 56.1 ± 3.4%) were detected in patients with complicated obesity (p < 0.05). Regardless of the obesity phenotype, correlations were established: between the level of diastolic blood pressure (DBP) and the volume of total (r1 = 0.42; r2 = 0.52) and extracellular fluid (r1 = 0.50; r2 = 0.60); level of DBP and urinary excretion of cystatin C (r1 = 0.51; r2 = 0.61) (p < 0.01). A decrease in the proportion of ACM in obese groups was associated with an increase in resistin levels (r1 = −0.56; r2 = −0.31). In obese groups, regardless of phenotype, fat mass was associated with leptin levels (r1 = 0.52; r2 = 0.42) and free leptin index (FLI) (r1 = 0.75; r2 = 0.46 ) (p < 0.05). In group 1, a positive correlation was additionally established for the volume of fat mass with systolic blood pressure (SBP) (r1 = 0.70) and DBP (r1 = 0.65), with the level of uric acid (r1 = 0.57), cholesterol LDL (r1 = 0.52), cystatin C in urine (r1 = 0.75) and insulin resistance index (HOMA-IR) (r1 = 0.65) (p < 0.01). Conclusion Body mass index does not determine the obesity phenotype. In patients with complicated obesity, the proportion of fat mass is higher than in metabolically healthy obesity and is associated with increased levels of glucose and uric acid. All obese patients are characterized by an increase in the percentage of total and extracellular fluid, associated with the level of blood pressure and urinary excretion of markers of tubular dysfunction.

The effect of abdominal obesity on the level of inflammatory markers in young people with hypertension

Objective: to investigate pro- and anti-inflammatory blood markers in young people with arterial hypertension (AH) against the background of abdominal obesity (AO).
 Materials and methods: the study included 530 people, including 267 people with hypertension, of which 169 were with AO. In the control group (without AH) there were 263 people comparable in gender and age, with AO - 106 people. The content of TNF-α, IL-6, IL-8, MCP-1 (monocytic chemoatractant protein), PAI-1 (plasminogen activator inhibitor-1), IL-10, IL-17a, IL-17e, IL-17f were determined in all blood by multiplex analysis. Statistical processing was carried out in the SPSS 13.0 program.
 Results: The level of IL-17a was 1.64 times higher in patients with hypertension (p0.05) compared to the control. The level of IL-6 in patients with hypertension was higher (p0.0001) by 52.91% compared to the group without hypertension. There was no difference between the control and the group with hypertension for the remaining biomarkers. The influence of AO on the level of the studied markers in the control group was not revealed. In the group with AH, a significantly higher level of PAI-1 (p0.05) was in the subgroup with AO. For subgroups with AO, the difference between patients without AH and with AH was manifested in a decrease in IL-17e and an increase in IL-6 in patients with AH (p0.05). No statistically significant difference was found for the remaining indicators. The relative chance of early hypertension was associated with the presence of AO and an increase in the level of IL-6.
 Conclusion: From the markers of inflammation studied by us, an increased level of IL-6 and IL-17a can serve as potential biomarkers indicating a high probability of developing early hypertension in people under 45 years of age.

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

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

Effects of epicatechin on cardiovascular function in middle-aged diet-induced obese rat models of metabolic syndrome.

The current study aimed to investigate the cardiovascular effects of epicatechin, a flavonoid found in green tea and cocoa, in attenuating complications associated with metabolic syndrome in diet-induced obese rats. Male Wistar-Kyoto (WKY) rats aged 16 weeks were fed either standard rat chow or given a high-fat-high-carbohydrate (HFHC) diet for 20 weeks. Epicatechin treatment (5 mg/kg/d) was administered to a subset of WKY rats commencing at week 8 of the 20 week HFHC feeding period. Body weights, food, water and energy intakes, blood pressure, heart rate and glucose tolerance were measured throughout the treatment period. Oxidative stress and inflammatory markers, lipid levels, cardiac collagen deposition, cardiac electrical function, aortic and mesenteric vessel reactivity were examined after the treatment. Twenty weeks of HFHC feeding in WKY rats resulted in the development of metabolic syndrome indicated by the presence of abdominal obesity, dyslipidaemia, glucose intolerance and increased blood pressure. Epicatechin treatment was found to enhance the oxidative stress status in HFHC groups through an increase in serum nitric oxide levels and a decrease in 8-isoprostane concentrations. Furthermore, WKY-HFHC rats displayed a decrease in IL-6 levels. The lipid profiles in HFHC groups showed improvement, with a decrease in LDL-cholesterol and TAG and an increase in HDL-cholesterol levels observed in WKY-HFHC rats. However, epicatechin was not effective in preventing weight gain, glucose intolerance or hypertension in HFHC fed rats. Overall, the results of this study suggest that epicatechin has the potential to improve the underlying mechanisms associated with metabolic syndrome in obese rats.

Associations of Fatty Acid Profile with Abdominal Obesity in Men.

The content of individual unsaturated fatty acids in blood plasma (measured by HPLC) and their association with abdominal obesity in a group of men (mean age 52.2 years) was analyzed. The abdominal obesity was diagnosed according to the criteria of the All-Russian Scientific Society of Cardiology (waist circumference >94 cm). Men with abdominal obesity had higher levels of ω-6 γ-linolenic and dihomo-γ-linolenic acids, as well as ω-3 eicosapentaenoic and docosahexaenoic acids. They also had significantly elevated plasma levels of triglycerides and glucose and lower levels of HDL. Using single-factor ROC analysis we determined optimal cut-off thresholds for fatty acid levels indicating the presence of abdominal obesity. The results of regression analysis showed that the level of γ-linolenic acid is directly associated with the chance of abdominal obesity.s.

Dynapenic abdominal obesity and incident multimorbidity: findings from the English longitudinal study on ageing

BackgroundDynapenic abdominal obesity (DAO) (i.e., impairment in muscle strength and high waist circumference) is gaining interest, as it is associated with several important adverse health outcomes. However, the association between DAO and multimorbidity is largely unclear. Thus, the aim of the present study was to investigate the association between DAO at baseline and new onset multimorbidity over ten years of follow-up.MethodsPeople participating in the English Longitudinal Study of Ageing were included. DAO was defined as waist circumference > 102 cm in men and > 88 cm in women, and a concomitant presence of dynapenia (handgrip strength defined as < 27 kg for men and < 16 kg for women). Multimorbidity was defined as having two or more chronic conditions. The association between DAO and incident multimorbidity was assessed using a multivariable logistic regression analysis, reporting the data as odds ratios (ORs) and their 95% confidence intervals (CIs).ResultsOverall, 3302 participants (mean age: 63.4 years, males: 50.3%) without multimorbidity at baseline were followed-up for ten years. After adjusting for several variables, compared to participants without dynapenia nor abdominal obesity, the presence of abdominal obesity (OR = 1.505; 95%CI: 1.272–1.780; p < 0.0001) and DAO (OR = 1.671; 95%CI: 1.201–2.325; p = 0.002) significantly increased the risk of multimorbidity. Compared to no dynapenia nor abdominal obesity, DAO was associated with significantly higher risk for arthritis and diabetes.ConclusionsDAO was significantly associated with a higher risk of incident multimorbidity, over 10 years of follow-up. The results of our study suggest that addressing DAO can potentially decrease risk for multimorbidity.

METABOLIC PREDICTORS OF TARGET ORGAN DAMAGE IN ESSENTIAL HYPERTENSION

Objective: First, to verify the relationship between hypertension-mediated organ damage (HMOD) and measures of abdominal obesity in essential hypertension. Secondly, to evaluate which condition between overweight (BMI&gt;25 kg/m2), high waist circumference (WC&gt;80/94 cm in females/males) and waist-to-height ratio (WHtR&gt;0.54) is more predictive of HMOD. Design and method: We selected a cohort of adult treated essential hypertensive subjects followed at our Hypertension Center. Blood pressure (BP), height, weight and WC were measured in all subjects. Various investigations were also performed to identify HMOD, such as echocardiography, carotid ultrasound, carotid-femoral pulse wave velocity (PWV) and fundoscopy. Results: 114 subjects were enrolled (46/68 females/males, mean age 69±2 years, mean BP 135/77±3/2 mmHg). WC and WHtR were higher in patients with all expressions of HMOD except for hypertensive retinopathy. In particular, left ventricular mass index (LVMi/BSA) correlates with WHtR (p&lt;0.05), while in obese subjects, in which ventricular mass was indexed as LVMi/h2.7, both WC and WHtR significantly correlate (p&lt;0.05). In subjects with WHtR&gt;0.54, there was a significant risk of increased arterial stiffness by PWVs (OR = 2.479, p = 0.04). This data is confirmed in subjects with BMI&gt;25 kg/m2 (OR = 2.888, p = 0.04) but not in subjects with BMI&lt;25 kg/m2, while no significance was observed for high WC. In the presence of HMOD, a significantly higher number of metabolic syndrome factors (MetS) was observed (3.1 vs. 2.06, p = 0.0008). An OR of 7.55 (p = 0.01) for the presence of HMOD was observed in subjects diagnosed with MetS. Conclusions: In our population, the presence of abdominal obesity may indicate a greater risk of developing HMOD (especially left ventricular hypertrophy and increased arterial stiffness) in essential hypertensive patients. WHtR may be a more sensitive indicator than WC. Furthermore, the significant increase in the risk of HMOD in the presence of MetS may indicate that the synergy between multiple risk factors correlates more strongly with the development of HMOD. Therefore, in the management of essential hypertension, it is of great importance to combine drug therapy with a strategy of reduction of abdominal adipose tissue and the other MetS factors.

Association of the metabolic syndrome components with the chronotype, level of daytime sleepiness and dispositional optimism in patients with arterial hypertension

Introduction: Arterial hypertension (AH) coexists with such conditions as obesity, insulin resistance/hyperinsulinemia and dyslipidemia, that is, interrelated metabolic disorders that characterize the metabolic syndrome (MS). The aim of the study was to establish relationships between components of MS and chronotype, level of daytime sleepiness, and dispositional optimism in patients with AH. Methods: The study included 42 patients diagnosed with stage 2 essential AH. To study the chronotype, we used the validated questionnaire “Composite Scale of Morningness” and scales from official available sources. Dispositional optimism (LOT-R) was assessed using a questionnaire adapted from O.A. Sychova. Epworth scale was used to assess the severity day sleepiness. Laboratory parameters were determined using commercially available kits. Results: The main components of the MS are found in more than half of the patients with AH, of which 61.90% have abdominal obesity, 42.86% have hypertriacylglycerolemia, 26.19% have hyperglycemia, and 66.67% have a decrease in HDL-C levels. Patients with AH with diagnosed components of MS have an evening chronotype, daytime sleepiness, and low optimism is diagnosed to the same extent as patients without MS. At the same time, evening (53.85%) and intermediate (38.46%) chronotypes are found in patients with abdominal obesity, and the frequency of daytime sleepiness registration, and a low level of optimism does not depend on the presence of abdominal obesity; patients with dyslipidemia are characterized by low optimism, evening and intermediate chronotypes, and severe daytime sleepiness; and a glucose level ≥5.6 mmol/l is registered in most patients with an evening chronotype. Conclusion: The research conducted showed significant relationships between abdominal obesity, dyslipidemia, hyperglycemia and evening chronotype, daytime sleepiness, and low optimism in patients with AH.

Abdominal obesity and dsyglycemia are risk factors for liver fibrosis progression in NAFLD subjects:A population-based study.

To investigate longitudinal changes in the liver stiffness measurement (LSM) in the general adult population without known liver disease and to describe its association with metabolic risk factors, with a special focus on subjects with non-alcoholic fatty liver disease (NAFLD) and dysglycemia. A longitudinal adult population-based cohort study was conducted in Catalonia. LSM was measured by transient elastography (TE) at baseline and follow-up (median: 4.2 years). Subgroup with NAFLD and dysglycemia were analyzed. Moderate-to-advanced liver fibrosis was defined as LSM ≥8.0 kPa and LSM ≥9.2 kPa respectively. Among 1.478 subjects evaluated, the cumulative incidence of LSM ≥8.0 kPa and ≥9.2 kPa at follow-up was 2.8% and 1.9%, respectively. This incidence was higher in NAFLD (7.1% for LSM ≥8.0 kPa and 5% for LSM ≥9.2 kPa) and dysglycemia (6.2% for LSM ≥8.0 kPa and 4.7% for LSM ≥9.2 kPa) subgroups. In the global cohort, the multivariate analyses showed that dysglycemia, abdominal obesity and atherogenic dyslipidemia were significantly associated with progression to moderate-to-advanced liver fibrosis. Female sex was negatively associated. In subjects with NAFLD, abdominal obesity and dysglycemia were associated with changes in LSM to ≥8.0 kPa and ≥9.2 kPa at follow-up. A decline in LSM value to <8 kPa was observed in 64% of those subjects with a baseline LSM ≥8.0 kPa. In this population study, the presence of abdominal obesity and dysglycemia were the main risk metabolic factors associated with moderate-to-advanced liver fibrosis development over time in general populations as well as in subjects with NAFLD.

Nutrient Patterns and Its Association and Metabolic Syndrome among Chinese Children and Adolescents Aged 7–17

This study was designed to explore the associations between nutrient patterns (NPs) and metabolic syndrome (MetS) and its five components among Chinese children and adolescents aged 7-17. The required data of participants were collected from the China National Nutrition and Health Surveillance of Children and Lactating Mothers in 2016-2017. Ultimately, 13,071 participants were included. Nutrient patterns were obtained by means of factor analysis. Multivariate logistic regression analysis was conducted to evaluate the association between nutrient patterns with MetS and its components. After adjusting covariates, the results of logistic regression models revealed that high-carbohydrate patterns were associated with the presence of abdominal obesity. The high-animal protein pattern was negatively associated with high triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C). The high-sodium-and-fat pattern had a negative relationship with elevated blood pressure (BP) and was positively associated with low HDL-C. The high-Vitamin D-and-Vitamin B12 pattern had protective effects on MetS, high TG, and low HDL-C. Further large-scale longitudinal investigations are necessary in the future.

Perindopril prevents development of obesity and hypertension in middle aged diet-induced obese rat models of metabolic syndrome

AimsThe therapeutic properties of anti-hypertensive medications that extend beyond blood pressure lowering have started to become important clinical targets in recent years. This study aimed to assess the cardioprotective effects of perindopril in attenuating complications associated with metabolic syndrome in diet induced obese rats. Main methodsMale Wistar-Kyoto (WKY) rats aged 16 weeks were fed either standard rat chow (SC) or given a high-fat-high-carbohydrate (HFHC) diet for 20 weeks. Perindopril treatment (1 mg/kg/day) was administered to a subset of WKY rats commencing at week 8 of the 20 week HFHC feeding period. Body weights, food, water and energy intakes, blood pressure, heart rate and glucose tolerance were measured throughout the treatment period. Oxidative stress and inflammatory markers, lipid levels, cardiac collagen deposition, vascular function, aortic and cardiac electrical function were examined after the treatment. Key findingsWKY rats developed metabolic syndrome after 20 weeks of HFHC feeding, evidenced by the presence of abdominal obesity, dyslipidaemia, glucose intolerance and hypertension. Perindopril treatment prevented the development of obesity and hypertension in WKY-HFHC. Perindopril improved blood lipid profiles in HFHC rats with decreases in LDL cholesterol, triglycerides and total cholesterol. Type I collagen levels were decreased in WKY-HFHC rats along with decreases in left ventricle mass. Perindopril treated rats also showed improved cardiac electrical function indicated by decreases in action potential at 90 % of repolarisation in WKY-HFHC rats. SignificanceThese results show that perindopril has a profound effect on preventing the development of metabolic syndrome in animals fed a HFHC diet.

The level of adipokines in young people with hypertension and abdominal obesity

Objective. To investigate the adipokine blood profile in young people with hypertension (HTN) and abdominal obesity (AO). Design and methods. In total. 530 people were included in the study, including 267 people with HTN, of which 169 had AO. In the control group (without HTN) there were 263 people comparable to the study group by gender and age. Among them there were 106 people with AO. The blood levels of adiponectin, adipsin, lipocalin-2, resistin and plasminogen activator inhibitor-1 (PAI-1) were determined in all examined patients by multiplex analysis. Statistical data processing was carried out with the use of SPSS 13.0 program. Results. The levels of adiponectin and lipocalin-2 were lower in the group of HTN patients by 1,46 (p &lt; 0,01) and 1,14 times (p &lt; 0,05), respectively. The level of adipsin in HTN patients was significantly higher (p &lt; 0,01) by 19,14 % compared to the control. The levels of resistin and PAI- did not differ in the control group and the group with HTN. Adiponectin level was 1,35 times lower (p &lt; 0,05) in the group with AO compared to those without AO, the other indicators did not differ in the AO group and controls. In the HTN group, higher levels of PAI-1 were found in the subgroup with AO. When comparing the subgroup without HTN and without AO with the subgroup with HTN and AO, a significant decrease in concentration of adiponectin and lipocalin-2 was found. For the subgroups with AO, a decrease in adiponectin levels and an increase in adipsin levels (p &lt; 0,01) were found in HTN patients. No statistically significant difference was found for the remaining indicators. The relative chance of early onset HTN was associated with the decrease in adiponectin and lipocalin-2 levels, and with the increase in adipsin levels, regardless of gender, age and the presence of AO. Conclusions. Thus, an increased level of adipsin and a reduced level of adiponectin and lipocalin-2 can serve as potential biomarkers indicating a high probability of developing early HTN in people under 45 years of age.

Study of oxidative stress indicators in young people with CHD in the background of abdominal obesity

Background and Aims : To study the parameters of oxidative stress characterizing antioxidant protection and oxidative damage in young people with coronary artery disease against the background of abdominal obesity.Methods: The study included 49 people aged 25 – 44 years with CHD and the presence/absence of abdominal obesity. Anamnestic data, anthropometry, functional examinations were collected from the all participants. Abdominal obesity (AO) was established based on waist circumference> 80 cm in women and> 94 cm in men. All patients were divided into two groups: 1 - with the presence of CHD and AO; 2 - with the presence of CHD without AO. The level of superoxide dismutase (SOD), total antioxidant capacity, MDA of modified oxidized LDL were determined in serum.Results: Among the studied parameters, the SOD level was statistically significantly different. In patients with the presence of AO, the SOD concentration is lower (p <0.001), in comparison with patients without AO. Indicators reflecting oxidative damage such as total antioxidant capacity and MDA of modified oxidized LDL did not differ significantly in the study groups. According to the results of our studies, SOD activity negatively correlated with BMI (r = -0.411, p = 0.016). In the group of patients without AO, a relationship was found between the MDA level of modified oxidized LDL and BMI (r = -0.507, p = 0.038).Conclusions: We have shown differences in some parameters of oxidative stress in young people with CHD, depending on the presence or absence of AO. This study was conducted within the framework of the project RSF 21-15-00022. Background and Aims : To study the parameters of oxidative stress characterizing antioxidant protection and oxidative damage in young people with coronary artery disease against the background of abdominal obesity. Methods: The study included 49 people aged 25 – 44 years with CHD and the presence/absence of abdominal obesity. Anamnestic data, anthropometry, functional examinations were collected from the all participants. Abdominal obesity (AO) was established based on waist circumference> 80 cm in women and> 94 cm in men. All patients were divided into two groups: 1 - with the presence of CHD and AO; 2 - with the presence of CHD without AO. The level of superoxide dismutase (SOD), total antioxidant capacity, MDA of modified oxidized LDL were determined in serum. Results: Among the studied parameters, the SOD level was statistically significantly different. In patients with the presence of AO, the SOD concentration is lower (p <0.001), in comparison with patients without AO. Indicators reflecting oxidative damage such as total antioxidant capacity and MDA of modified oxidized LDL did not differ significantly in the study groups. According to the results of our studies, SOD activity negatively correlated with BMI (r = -0.411, p = 0.016). In the group of patients without AO, a relationship was found between the MDA level of modified oxidized LDL and BMI (r = -0.507, p = 0.038). Conclusions: We have shown differences in some parameters of oxidative stress in young people with CHD, depending on the presence or absence of AO. This study was conducted within the framework of the project RSF 21-15-00022.

PREDICTORS OF CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS TREATED WITH EMPAGLIFLOZIN

Objective: Currently, it’s not well known what factors influenced the incidence of heart failure with preserved ejection (HFpEF) fraction in patients receiving sodium glucose co-transporter 2 inhibitors (SGLT2i). Objective: To evaluate predictors of HFpEF in patients with type 2 diabetes mellitus (T2DM) receiving SGLT2i Design and method: It was a prospective study in patients with T2DM. Inclusion criteria were: male and female, age 40–65 years, T2DM with duration at least for 1 year, absence of established atherosclerotic cardiovascular disease and HF. Exclusion criteria were: type 1 diabetes mellitus, glycated hemoglobin (HbA1c)&gt; 11% at screening, insulin therapy, atrial fibrillation, clinically significant valvular heart disease, chronic kidney disease, other serious conditions that would make the patient unsuitable for participation in the study. Clinical, laboratory (including biomarkers such as NT-proBNP, sST2, galectin-3, PICP,PIIINP,MMP-9,TIMP-1) and instrumental (echocardiography) data were collected at baseline. Empagliflozin 10 mg daily was prescribed for all patients. After 3 years of follow-up, information about HF events (hospitalization for HF, established HF in outpatient department by cardiologist), other clinically important data were obtained. Results: Seventy-five patients were included in the study. The mean age was 58 (47.9;65.1) years, 45,1% were female. Most patients had T2DM for more than 4 years. Mean HbA1c was 8.6% (7.6;9.5), all patients received oral antihyperglycemic medications. After 3 years of follow-up HFpEF was established in 16 patients. The HF group had higher waist circumference values, higher Nt-proBNP, galectin-3 and P1CP levels at baseline than patients without HF (all p &lt; 0.05). The threshold for galectin-3 level associated with increased risk of HFpEF in this population was 10.3 ng/ml (AUC area = 0.86; sensitivity, 87%; and specificity, 73%; p &lt; 0.001). Multiple logistic regression analysis identified significant risk factors for new onset of HFpEF: age&gt; 60 years, diabetes duration&gt; 10 years and presence of abdominal obesity were independent predictors of HFpEF. Galectin-3 level &gt; 10 ng/ml was associated with increased risk of HF incidence (OR = 2.15; 95% CI, 1.80–5.21; p = 0.01). Conclusions: Predictors for incidence HFpEF in patients with T2DM were age, diabetes duration, presence of abdominal obesity and galectin-3 levels higher than 10 ng/ml.

Association of abdominal obesity with the development of fatal and non-fatal cardiovascular events in a cohort of rural residents of the Kyrgyz Republic: gender and ethnic characteristics

Objective . To study the relationship of abdominal obesity (AO) with the development of fatal and non-fatal cardiovascular events among residents of the Chui region of the Kyrgyz Republic, taking into account gender and ethnicity. Design and methods . This study was carried out as part of the international epidemiological study “Interepid”. The total follow-up period was 7 years. Life status at the end of the follow-up was monitored in 1096 respondents out of 1341 initial cohorts (response 82,1%). Cases of fatal and non-fatal cardiovascular events were included as endpoints in the analysis. The frequency of events was assessed using methods of analysis of survival (Cox proportional hazard regression model, parametric survival models, Kaplan–Meier survival analysis). Results . 181 cases of fatal and non-fatal cardiovascular events (16,44%) were registered during the follow-up. A significant effect of AO on the incidence of cardiac complications in the analyzed cohort was demonstrated. Thus, in respondents with AO, the total frequency of cardiovascular events reached 21,31% and was significantly higher than in those without AO (10,69%, p &lt; 0,0001). An increase in the frequency of events in the presence of AO was recorded in all analyzed subgroups (men, women, Russians, Kyrgyz). The construction of a Cox regression model with a logistic regression analysis made it possible to confirm the independent role of AO in the development of fatal and non-fatal cardiovascular events, which was most pronounced in women and respondents of the Kyrgyz ethnic group. At the same time, on average for the cohort, an increase in waist circumference value by 1 cm is accompanied by an increase in cardiovascular risk by 1,9%. Conclusions . The presence of AO is an independent risk factor for the development of fatal and non-fatal cardiovascular events in the analyzed cohort of residents of the Chui region, mostly among women and respondents of the Kyrgyz ethnic group.

Gender-Based Association of Coronary Artery Calcification and Framingham Risk Score With Non-alcoholic Fatty Liver Disease and Abdominal Obesity in Taiwanese Adults, a Cross-Sectional Study.

BackgroundIt is not certain whether non-alcoholic fatty liver disease (NAFLD) or abdominal obesity (AO) has stronger associations with atherosclerosis and coronary artery disease (CAD) risk across different genders. The purpose of this study was to determine the gender-based association of NAFLD and AO with subclinical atherosclerosis represented by coronary artery calcification (CAC) and CAD risk by Framingham risk score (FRS).MethodsA total of 1,655 participants in a health-screening program (mean age: 49.44 years; males: 70.33%) were enrolled for analysis. Fatty liver and coronary artery calcium score (CACS) were measured via ultrasonography (US) and multi-detector computed tomography (MDCT). The presence of CAC was defined as having a CACS > 0, intermediate to high CAD risk was defined as FRS ≥ 10%, while the presence of AO was defined as having a waist circumference (WC) of ≥90 cm for men and ≥80 cm for women. Participants were categorized into four groups depending on the presence or absence of NAFLD and/or AO.ResultsThe percentage of subjects with CACS > 0 was highest in the AO-only group (overall: 42.6%; men: 48.4%; women: 35.8%); and FRS ≥ 10% was highest in the group with both abnormalities (overall: 50.3%%; men: 57.3%; women: 32.4%). After adjustment factors, the odds ratio (OR) for CAC and FRS was the highest in the group with both abnormalities [men: 1.61 (1.13–2.30) for CACS > 0 and 5.86 (3.37–10.20) for FRS ≥ 10%; women: 2.17 (1.13–4.16) for CACS > 0 and 6.31 (2.08–19.10) for FRS ≥ 10%]. In men, the OR of NAFLD was higher than that of AO [1.37 (1.03–1.83) vs. 1.35 (1.02–1.79) for CACS > 0, 3.26 (2.13–4.98) vs. 2.97 (1.91–4.62) for FRS ≥ 10%]. However, women with AO consistently showed increased OR for CACS > 0 [1.87 (1.11–3.16)] and FRS ≥ 10% [4.77 (2.01–11.34)].ConclusionThe degree of association of NAFLD and AO with CAC and FRS depends on the gender. NAFLD is more closely associated with CACS > 0 and FRS ≥ 10% in men and AO in women, respectively. NAFLD and AO could be considered independent determinants of CAC and FRS by gender.

Abstract EP19: Obesity And Diabetes Risk According To Age Groups; An Analysis Of The National Health Screening Program For The People In Transition In Korea

Objective: The prevalence of type 2 diabetes mellitus (DM) and obesity is increasing among young population. However, the effect of obesity on the development of diabetes in different age groups is unclear. Therefore, we assessed the risk of development of future DM in two different age groups without diabetes at baseline, according to baseline body mass index (BMI) and waist circumference (WC). Research Design and Methods: The Korean National Health Insurance Service record, a nationwide population-based cohort was used to retrospectively analyze 4,145,321 Korean adults without DM, who had national health screening in Korea between 2009 and 2014. We included participants with mean age of 40 (n=2,905,752) and 66 (n=1,239,569) years old. Participants were categorized into 5, and 6 groups based on their BMI and WC, respectively. Each participant was followed either until 2017 or until the new diagnosis of DM was made. We assessed the risk of developing DM based on BMI and WC. Obesity (O) was defined as BMI≥25. Abdominal obesity (AO) was defined as WC ≥ 90cm for men, and ≥85cm for women. Multiple confounding factors were adjusted for multivariable analysis. Results: The median duration of follow-up was 5.6 years. In a multivariable analysis, higher BMI and WC among subjects with a mean age of 40 were associated with a higher risk of developing DM in the future. There was a linear association between BMI, WC, and the risk of DM (BMI&lt;18.5, ref; BMI≥30, HR 10.35, P trend &lt;0.001; WC 75-80 cm, ref; WC≥100 cm, HR 3.23, P trend &lt;0.001). A similar pattern was observed among patients with mean age 66 years old (BMI&lt;18.5, ref; BMI≥30, HR 3.16, P trend &lt;0.001; WC 75-80cm, ref; WC≥100, HR 1.98, P trend &lt;0.001). When participants were categorized based on the presence of O and AO, AO had a stronger impact on the development of DM than O in the 66 years old group (O(-)/AO(-), ref; O(-)/AO(+), HR 1.55; O(+)/AO(-), HR 1.45; O(+)/AO(+), HR 2.09). At the same time, O had a stronger impact on DM development than AO in the 40 years old group. (O(-)/AO(-), ref; O(-)/AO(+), HR 2.18; O(+)/AO(-), HR 2.62; O(+)/AO(+), HR 4.94). Conclusions: Regardless of age, both obesity and abdominal obesity increase the risk of DM. Among younger people, obesity was associated with a higher impact on the risk of DM. In older adults, the presence of abdominal obesity might have a greater effect on the development of DM in the future.

Relationship of lipid metabolism disorders with the development of fatal and non-fatal cardiovascular events in residents of the Chui region of the Kyrgyz Republic of varying sex and ethnicity

Aim. To study the relationship of lipid metabolism disorders (overweight, general and abdominal obesity (AO)) with the development of fatal and non-fatal cardiovascular events (CVEs) among residents of the Chui region of the Kyrgyz Republic of varying sex and ethnicity.Material and methods. This study was performed as part of the international prospective epidemiological project “Interepid”. The total follow-up period was 7 years. Vital status at the end of the follow-up period was monitored in 1096 respondents from 1341 initial cohorts. Response rate was 82,1%. As an endpoint, the analysis included cases of fatal and non-fatal CVEs. The prevalence of events was assessed by survival analysis methods (Cox proportional hazard regression model, parametric survival models, Kaplan-Meier estimator).Results. In total, 181 (16,44%) cases of fatal and non-fatal CVEs were recorded during the follow-up period. In individuals with normal body weight, the incidence of CVEs was 10%. In overweight persons, it increased and reached 17,99% (p&lt;0,001), while in those with obesity — 24,5% (p&lt;0.0001). An increase in CVE rate with an increase in body mass index was recorded in all analyzed subgroups (men, women, Russians, Kyrgyz). Cox regression model with a logistic regression analysis made it possible to confirm the independent role of general and AO in the development of fatal and non-fatal cardiac and cerebral accidents in both ethnic groups in women, but not in men.Conclusion. An increase in body mass index &gt;25 kg/m2 and the presence of AO are independent risk factors for fatal and non-fatal CVEs in the analyzed cohort of residents of the Chui region in women (but not men) of both ethnic groups.

Prevalence of hypercholesterolemia in young people under 45 years old with abdominal obesity in Novosibirsk

The study was devoted to the study of the prevalence of hypercholesterolemia (hyper-Chol) and hypercholesterolemia of low density lipoproteins (hyper-LDL-C) against the background of abdominal obesity (AO) in a population aged 25–44 years in Novosibirsk. Material and methods. A crosssectional survey of the population aged 25–44 years in Novosibirsk (Russia) was carried out. 1415 people were examined, including 670 men (47.3 %) and 745 women (52.7 %), pregnant women or being on maternity leave were not included in the study). All subjects were assessed for the presence of AO, hyper-Chol and hyper-LDL-C. Results. Individuals with AO had higher average values of total cholesterol and LDL cholesterol. The prevalence of hyper-Chol in individuals with AO was 1.3 times higher and hyper-LDL-C – 1.2 times higher than in individuals without AO. In women with AO, the prevalence of hyper-Chol was 1.2 times higher and hyper-LDL-C – 1.3 times higher than in women without AO. In men with AO, the prevalence of hyper-Chol was 1.4 times higher and hyper-LDL-C – 1.2 times higher than in men without AO. When conducting logistic regression analysis, it was found that in a young population under 45 years of age, abdominal obesity was significantly associated with the presence of atherogenic hypercholesterolemia in both sexes. In men, significant associations of AO with both hyper-Chol and hyper-LDL-C were noted, in women – only with hyper-LDL-C. Conclusions. A population study of young people (25–44 years old) revealed associations of atherogenic hypercholesterolemia with abdominal obesity.

Influence of the Driving Pressure on Mortality in ARDS Patients with or without Abdominal Obesity: A Retrospective Cohort Study.

Objective This study sets out to explore if the relationship between the driving pressure and hospital mortality in ARDS patients is influenced by body mass index (BMI) level or the presence of abdominal obesity. Methods Data were extracted from an online database named “Multiparameter Intelligent Monitoring in Intensive Care III.” A total of 1556 patients were included and divided into four subgroups based on both BMI level (BMI ≥30 kg/m2 or BMI ＜30 kg/m2) and abdominal assessment. Driving pressure [i.e., the difference between plateau pressure and positive end-expiratory pressure (PEEP)] within 24 h of invasive mechanical ventilation was compared between survivors and nonsurvivors during hospitalization in each group. A logistic regression model was used for hospital mortality. Results There were 1556 patients with mild-to-severe ARDS, 666 (42.80%) nonobese patients with nonabdominal obesity, 259 (16.65%) nonobese patients with abdominal obesity, 97 (6.23%) obese patients with nonabdominal obesity, and 534 (34.32%) obese patients with abdominal obesity. Driving pressure in nonobese patients with nonabdominal obesity was significantly lower in survivors (12.77 ± 4.53 cm H2O) than in nonsurvivors (14.26 ± 5.52 cm H2O, p < 0.01). On the contrary, in the other three groups, driving pressure was not significantly different between survivors and nonsurvivors. After a logistic multivariable regression analysis, in nonobese (BMI<30 kg/m2) patients with nonabdominal obesity, the driving pressure was independently associated with increased hospital mortality (OR: 1.04, 95% CI 1.00–1.09, p < 0.05) but not in the other three subgroups. Conclusion Driving pressure is associated with increase in hospital mortality only in nonobese (BMI <30 kg/m2) patients with nonabdominal obesity.