Various Measures Of Obesity Research Articles

DNA polymorphisms in inflammatory and endocrine signals linked to frailty are also associated with obesity: data from the FRASNET cohort.

Obesity and frailty are prevalent geriatric conditions that share some pathophysiological mechanisms and are associated with adverse clinical outcomes. The relationship between frailty, obesity, and polymorphism remains inadequately explored. Single nucleotide polymorphisms (SNPs) offer insights into genetic predispositions that may influence the development of both frailty and obesity. We aimed at investigating whether SNPs associated with frailty also play a role in obesity. Data were collected from the FRASNET cross-sectional study, which included community-dwelling older individuals residing in Milan and nearby areas. Participants were recruited through random sampling. They underwent multidimensional geriatric assessments, which included the collection of blood samples for SNP analysis. Frailty was assessed using the frailty index, and body composition was evaluated using bioelectrical impedance analysis and anthropometric measures. SNPs related to frailty and linked to the renin-angiotensin system (CYP11B2 rs1799998, AGT rs5051, and AGTR1 rs2131127), apoptosis pathways (CASP8 rs6747918), growth hormone signaling (GHR rs6180), inflammation (TLR4 rs5030717, CD33 rs3865444, and FN1 rs7567647), adducin (ADD3 rs3731566), and the 9p21-23 region (rs518054) were found to be associated with various measures of obesity in community-dwelling older adults. Frailty-related SNPs contribute to obesity in community-dwelling older adults. We identified a novel association between adducin SNPs and visceral fat, which has not been previously reported. Detecting genetic predispositions to obesity and frailty early could aid in identifying individuals at risk, facilitating the adoption of preventive interventions. This represents an initial step toward promoting early intervention strategies.

Exploring Adiposity and Chronic Kidney Disease: Clinical Implications, Management Strategies, Prognostic Considerations.

Obesity poses a significant and growing risk factor for chronic kidney disease (CKD), requiring comprehensive evaluation and management strategies. This review explores the intricate relationship between obesity and CKD, emphasizing the diverse phenotypes of obesity, including sarcopenic obesity and metabolically healthy versus unhealthy obesity, and their differential impact on kidney function. We discuss the epidemiological evidence linking elevated body mass index (BMI) with CKD risk while also addressing the paradoxical survival benefits observed in obese CKD patients. Various measures of obesity, such as BMI, waist circumference, and visceral fat assessment, are evaluated in the context of CKD progression and outcomes. Mechanistic insights into how obesity promotes renal dysfunction through lipid metabolism, inflammation, and altered renal hemodynamics are elucidated, underscoring the role of adipokines and the renin-angiotensin-aldosterone system. Furthermore, the review examines current strategies for assessing kidney function in obese individuals, including the strengths and limitations of filtration markers and predictive equations. The management of obesity and associated comorbidities like arterial hypertension, type 2 diabetes mellitus, and non-alcoholic fatty liver disease in CKD patients is discussed. Finally, gaps in the current literature and future research directions aimed at optimizing the management of obesity-related CKD are highlighted, emphasizing the need for personalized therapeutic approaches to mitigate the growing burden of this intertwined epidemic.

Relationship between gout, hyperuricemia, and obesity-does central obesity play a significant role?-a study based on the NHANES database.

Our objective was to evaluate how various measures of obesity, such as body mass index(BMI), body roundness index(BRI), and weigh adjusted waist index(WWI), influence urate levels, prevalence of gout and to compare the disparities among these obesity indicators. By analyzing the 2001-2018 National Health and Nutrition Examination Survey (NHANES), we assessed the relationship between BMI, WWI, and BRI indices and urate levels, hyperuricemia, and the prevalence of gout. Smoothed curve fitting was used to determine whether there was a nonlinear relationship between BMI,WWI, and BRI indices and urate levels, hyperuricemia, and the prevalence of gout, and threshold effects analysis was used to test this relationship. We also used ROC curves to determine the diagnostic efficacy of BMI, WWI, and BRI on the prevalence of hyperuricemia and gout. The study incorporated a total of 29,310 participants aged over 20 years, out of which 14,268 were male. Following the adjustment for the pertinent confounding factors, it was observed that higher levels of BMI, WWI, and BRI were significantly associated with a gradual and dose-dependent increase in urate levels. In the sensitivity analysis, each unit increment in BMI, WWI, and BRI levels exhibited an 8%, 72%, and 26% respective elevation in the risk of hyperuricemia, as well as a 5%, 31%, and 15% respective increase in the risk of gout. Dose-response curves provided evidence of a linear positive correlation between BMI, WWI, BRI, and urate levels, as well as the prevalence of hyperuricemia and gout. Based on the response from the ROC curve, overall, the diagnostic efficacy of BRI for hyperuricemia and gout surpasses that of BMI. The central obesity indices WWI and BRI levels are superior to BMI in detecting the prevalence of urate levels, hyperuricemia, and gout, and although a clear causal relationship has not yet been established, it is important to recognize the impact of central obesity on uric acid levels and to give it due attention.

Physical activity and its correlation with various measures of obesity among medical students and young faculty

BackgroundPhysical inactivity is important modifiable risk factor for major NCDs. Medical students and faculty who are physically active are more probable to prescribe physical activity to their patients, drastically improving clinical outcomes. Objectives1) To describe physical activity of participants in terms of pattern, type & levels. 2) To correlate physical activity with various measures of obesity. MethodsThis cross-sectional study was conducted among 350 medical students and young faculty aged 18–35 years. Physical activity was assessed using WHO GPAQ. Physical activity pattern was described in work, travel and leisure domains. It was classified into vigorous and moderate intensity activity types. Levels were defined as insufficiently, moderately and highly active. Measurement of various obesity parameters was done. Data was analyzed using SPSS v25.0. ResultsOf all respondents, 193 (55.14%) were males and 157 (44.86%) were females. The prevalence of insufficient physical activity was 20.57%. Respondents reported highest physical activity in leisure domain (1222.45 ± 1590.8 mean METM/W). BMI was significantly correlated with physical activity in transport (p = 0.018) and leisure (p < 0.0001) domains. Neck circumference was significantly correlated with physical activity in transport (p = 0.018) and leisure (p < 0.0001) domains. Waist circumference was significantly correlated with physical activity in leisure domain (p < 0.0001).Waist circumference (p = 0.036) and neck circumference (p = 0.004) were significantly correlated with levels of physical activity. Total 327 (93.42%) respondents reported sedentary time >6 h/day. ConclusionThis population needs to adopt changes in their lifestyle to increase physical activity especially in travel domain with reduction in sedentary time.

Obesity and lung cancer-a narrative review.

A highly nuanced relationship exists between obesity and lung cancer. The association between obesity and lung cancer risk/prognosis varies depending on age, gender, race, and the metric used to quantify adiposity. Increased body mass index (BMI) is counterintuitively associated with decreased lung cancer incidence and mortality, giving rise to the term 'obesity paradox'. Potential explanations for this paradox are BMI being a poor measure of obesity, confounding by smoking and reverse causation. A literature search of this topic yields conflicting conclusions from various authors. We aim to clarify the relationship between various measures of obesity, lung cancer risk, and lung cancer prognosis. The PubMed database was searched on 10 August 2022 to identify published research studies. Literature published in English between 2018 and 2022 were included. Sixty-nine publications were considered relevant, and their full text studied to collate information for this review. Lower lung cancer incidence and better prognosis was associated with increased BMI even after accounting for smoking and pre-clinical weight loss. Individuals with high BMI also responded better to treatment modalities such as immunotherapy compared to individuals with a normal BMI. However, these associations varied highly depending on age, gender, and race. Inability of BMI to measure body habitus is the main driver behind this variability. The use of anthropometric indicators and image-based techniques to quantify central obesity easily and accurately is on the rise. Increase in central adiposity is associated with increased incidence and poorer prognosis of lung cancer, contrasting BMI. The obesity paradox may arise due to the improper use of BMI as a measure of body composition. Measures of central obesity better portray the deleterious effects of obesity and are more appropriate to be discussed when talking about lung cancer. The use of obesity metrics based on anthropometric measurements and imaging modalities has been shown to be feasible and practical. However, a lack of standardization makes it difficult to interpret the results of studies using these metrics. Further research must be done to understand the association between these obesity metrics and lung cancer.

Functional variants in cytochrome b5 type A (CYB5A) are enriched in Southwest American Indian individuals and associate with obesity.

ObjectiveThis study aimed to identify genetic variants enriched in Southwest American Indian (SWAI) individuals that associate with BMI.MethodsWhole genome sequencing data (n = 296) were used to identify potentially functional variants that are common in SWAI individuals (minor allele frequency ≥10%) but rare in other ethnic groups (minor allele frequency < 0.1%). Enriched variants were tested for association with BMI in 5,870 SWAI individuals. One variant was studied using a luciferase reporter, and haplotypes that included this variant were analyzed for association with various measures of obesity (n = 917‐5,870), 24‐hour energy expenditure (24‐h EE; n = 419), and skeletal muscle biopsy expression data (n = 207).ResultsA 5′ untranslated region variant in cytochrome b5 type A (CYB5A), rs548402150, met the enrichment criteria and associated with increased BMI (β = 2%, p = 0.004). Functionally, rs548402150 decreased luciferase expression by 30% (p = 0.003) and correlated with decreased skeletal muscle CYB5A expression (β = −0.5 SD, p = 0.0008). Combining rs548402150 with two splicing quantitative trait loci in CYB5A identified a haplotype carried almost exclusively in SWAI individuals that associated with increased BMI (β = 3%, p = 0.0003) and decreased CYB5A expression, whereas the most common haplotype in all ethnic groups associated with lower BMI and percentage of body fatness, increased 24‐h EE, and increased CYB5A expression.ConclusionsFurther studies on the effects of CYB5A on 24‐h EE and BMI may provide insights into obesity‐related physiology.

88 Prospective Association of Obesity and Falls among Malaysian Community-Dwelling Older Adults

Abstract Background Cross-sectional studies linking the association between obesity and falls are limited and their results are somewhat conflicting. The inconsistent evidence between obesity and falls could be explained by the utilization of different measures of obesity including BMI, WC, waist hip ratio (WHR) and percentage body fat (%BF) in different studies. Aims To examine the prospective association between various measures of obesity and falls among community-dwelling older adults. Methods We utilized data from the wave 1 and wave 2 of the Malaysian Elder’s Longitudinal Research Study (MELoR). Basic demographic characteristics, medical history, lifestyle factors and falls history in preceding 12 months was recorded by computer assisted questionnaire in participant’s home while anthropometric measurements, body composition assessments and physical performance were collected at the hospital during a hospital check-up at baseline. The main exposure variables were increased body mass index (BMI), waist circumference (WC), waist hip ratio (WHR) and percentage body fat (%BF) and the main outcome was self-report falls in the preceding 12 months at time of follow-up. Results Among 746 participants at baseline and follow-up (mean age 68.9 ± 7.3 years, old, 56.7% women), 150(20.1%) individuals had ≥1 time of fall at follow-up. No differences in mean age and proportion of men and women among fallers and non-fallers. However, fallers were found to have higher WHR, lower percentage muscle mass and performed poorer in physical performance (p-value&amp;lt;0.01). Of the four obesity indicators, higher WHR at baseline was associated with increased risk of fall 12 months later even after adjustment for all potential confounders (aOR= 2.01; 95%CI= 1.26-3.18). Conclusions In conclusion, our findings suggest that WHR is the measure of adiposity most likely to differentiate fallers from non-fallers prospectively. Future studies should evaluate the mechanisms underlying the increased risk of falls associated with increased WHR.

THE RELATIONSHIP BETWEEN PULSE WAVE VELOCITY, RENAL RESISTIVE INDEX AND MEASURES OF OBESITY IN HYPERTENSIVE PATIENTS WITH CORONARY ARTERY DISEASE

Objective:Recent data suggest that the intrarenal resistive index (RI) may be associated with systemic vascular changes and aortic stiffness. However, conflicting data exist about the relationship between arterial stiffness and RI. Data regarding the predictive value of various measures of obesity i

Abstract P301: Obesity and Mortality: the Jackson Heart Study

Background: Mortality has been reported to be lower among individuals classified as overweight/obese (based on body mass index (BMI, kg/m 2 )) when compared with their normal weight counterparts (“obesity paradox”). One possible reason for this apparent paradox is that BMI includes the weight of lean muscle and fat mass, both of which vary with age, sex, and race/ethnicity, and variations in these individual mass measures may not be reflected by the BMI. We compared associations between all-cause mortality and BMI and other obesity measures that may better reflect central adiposity, including waist circumference (WC, cm), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) in the Jackson Heart Study (JHS), a prospective cohort study of cardiovascular disease in African Americans. Methods: Data from 3,976 JHS participants (441 deaths) who attended Exam 2 (2005-2008) where various measures of obesity were collected, were analyzed. Cox regression models were used to evaluate the associations between obesity and all-cause mortality. “Time 0” for the survival analysis was the date of Exam 2 and the administrative censoring date was 12/31/2015. Obesity measures were analyzed as categories based on standard cut-points defining obesity and as quintiles. Covariates include age, sex and smoking. The predictive abilities of these obesity measures were assessed using c-index. Results: The age-sex-smoking adjusted mortality rates were the lowest among participants who were overweight (BMI 25-&lt;30) or with class I obesity (BMI 30-&lt;35). However, compared to normal weight participants (BMI 18.5-&lt;25), only participants with class III obesity (BMI ≥40) had a significantly higher mortality (adjusted HR [aHR] 1.92 [95% CI 1.34-2.75]). In addition, higher mortality was associated with obesity defined by WC (&gt;102 in men/&gt;88 in women vs. ≤102 in men/≤88 in women; aHR 1.45 [1.16-1.82]) and by WHR (≥0.9 in men/≥0.85 in women vs. &lt;0.9 in men/&lt;0.85 in women; aHR 1.54 [1.21-1.95]); but not by BMI (≥30 vs. &lt;25; aHR 1.04 [0.79-1.37]) or WHtR (≥0.5 vs. &lt;0.5; aHR 1.03 [0.72-1.49]). Sex-stratified analyses suggest the stronger predictor for mortality was WC-defined obesity in men and WHR-defined obesity in women; however, test for interactions were not statistically significant. The associations were not found to vary by age (&gt;65 vs. ≤65 years). Analyses using quintiles showed that the 5 th quintiles were associated with a significant increase in mortality compared with the 1 st quintiles for all obesity measures. The c-indexes were comparable for all obesity measures. Conclusions: The “obesity paradox” was suggested in the JHS based on BMI. However, only morbidly obese participants had a significantly higher mortality than normal weight participants. The recommended cut-points for defining obesity based on WC and WHR were significantly associated with increased mortality in this large cohort of African Americans.

Electroanatomical Remodeling oftheAtria in Obesity: Impact of Adjacent Epicardial Fat.

The aims of the study were to characterize: 1) electrical and electroanatomical remodeling in patients with atrial fibrillation (AF) with obesity; and 2) the impact of epicardial fat depots on adjacent atrial tissue. Obesity is associated with an increased risk of AF. A total of 115 patients with AF who underwent AF ablation were screened. After exclusion, 26 patients were divided into 2 groups (obese: body mass index [BMI]≥27 kg/m2 and reference: BMI<27 kg/m2). They underwent cardiac magnetic resonance (CMR) imaging and electroanatomic mapping of the left atrium (LA) in sinus rhythm before AF ablation. Atrial and ventricular epicardial adipose tissue (EAT) were assessed by CMR. The following electrophysiological parameters were assessed: global and regional voltage, conduction velocity (CV), electrogram fractionation, and CV heterogeneity. In addition, the regional relationship between LA EAT depots and the electrophysiological substrate was evaluated. The BMIs of the obese and reference groups were 30.2 ± 2.6 and 25.2 ± 1.3 kg/m2, respectively (p< 0.001). There was no difference in the left ventricular ejection fraction and a nonsignificant increase in LA size with obesity. Obesity was associated with increase in all measures of EAT (p< 0.05), with a predominant distribution adjacent to the posterior LA and the atrioventricular groove. Obesity was associated with reduced global CV (0.86 ± 0.31 m/s vs. 1.26 ± 0.29 m/s; p< 0.001), with a nonsignificant increase in conduction heterogeneity (p= 0.10), increased fractionation (54 ± 17% vs. 25 ± 10%; p< 0.001), and regional alteration in voltage (p< 0.001). Although the global LA voltage was preserved, there was greater voltage heterogeneity (p= 0.001) and increased low-voltage areas (13.9% vs. 3.4%; p< 0.001) in the obese group compared with the reference group. The low voltage areas were predominantly seen in the posterior and/or inferior LA, which was similar to location of EAT on CMR imaging. Among various measures of obesity, LA EAT volume correlated best with posterior LA fractionation (r2= 0.55 for LA EAT volume vs. r2= 0.36 for BMI) and CV (r2= 0.31 for LA EAT volume vs. r2= 0.22 for BMI). Obesity is associated with electroanatomical remodeling of the atria, with areas of low voltage, conduction slowing, and greater fractionation of electrograms. These changes were more pronounced in regions adjacent to epicardial fat depots, which suggested a role for fat depots in the development of the AF substrate.

Relationships between self-reported asthma and pulmonary function and various measures of obesity

ABSTRACTObjective: We explore the association with self-reported asthma and pulmonary function based on spirometry measurements using different measures to determine obesity because body mass index (BMI) is limited in not differentiating fat and muscle mass. Methods: A multi-year cross-sectional study using Korean National Health and Nutrition Examination Survey data was conducted between July 2008 and May 2011. A total of 9409 subjects were included in the final analysis. Results: Obesity was associated with self-reported asthma and pulmonary function limitations mainly in adult women aged between 40 and 65 years and elderly men aged 65 or older. The association was stronger when the measurement of obesity was based on body fat percentage or waist-to-height ratio (WHtR), compared to BMI. There was a higher self-reported asthma risk among obese women according to the WHtR [odds ratio (OR) = 1.817, 95% CI: (1.208, 2.735)]. There was an increased risk of pulmonary function limitation with abdominal obesity [OR 1.418, 95% CI (1.020, 1.972)], weight-to-height ratio [OR 1.467, 95% CI (1.058, 2.034)], and obesity with regard to body fat percentage [OR 1.753, 95% CI (1.251, 2.457)] in adult women. In elderly men, obesity based on body fat percentage was associated with an increased risk of pulmonary function limitation [OR 1.93, 95% CI (1.098, 3.388)]. Conclusions: Measures other than BMI should be examined when investigating the effect of obesity on self-reported asthma and pulmonary function limitation.

Mapping of Reviews on Breastfeeding and Obesity Risk in Children

Globally, breastfeeding rates continue to decline while childhood obesity rates remain high. A comprehensive understanding of the relationship between breastfeeding and obesity and the identification of gaps in the current literature is necessary to determine the next steps in research and health promotion efforts in this area. The purpose of this paper was to conduct a systematic mapping of reviews in order to evaluate the current literature and determine the associations between breastfeeding and childhood obesity risk. Medline (1946 to present), PubMed (NLM), Embase (1947 to present), Cochrane, PsycINFO, and CINAHL were searched. The studies had to be review articles looking at the association between breastfeeding and obesity. Only peer-reviewed articles published in English between 1946 and May 17, 2016 with available full texts were included in the final mapping of reviews. Twenty-nine review articles were included of which nine were meta-analyses. Variation in operationalization of exposure (breastfeeding) and outcome (overweight/obesity) variables is one of the most notable findings among the various systematic reviews. Breastfeeding was classified either as ever versus never or exclusive versus not exclusive or breastfeeding versus bottle-feeding or a combination of the three. There was variability in measurement of the duration of exclusive breastfeeding, which ranged from 12 months with majority between 1 and 6 months. Overweight and obesity was also variously classified using different parameters including weight status, BMI percentile, weight for length, waist-hip circumference, skinfold thickness, and various measures of obesity (fat mass, percent fat mass, and fat-free mass). Results support a strong inverse association between breastfeeding and risk of obesity in the child. Covariates influencing this association included birth weight, socioeconomic status, maternal smoking, parental weight status, and sibling status (in twin studies). Breastfeeding initiation, duration, and exclusivity were the three ways in which breastfeeding was operationalized, while weight status and BMI were the predominant ways in which child obesity was measured. Future research focusing on a geographically and ethnically diverse population, using experimental designs, and longer duration of follow-up in the child is warranted.

Obesity and risk of bleeding: the SMART study.

Essentials Whether obesity protects against clinically relevant bleeding is unclear. We investigated the risk of bleeding according to various measures of obesity in a cohort of 9736 patients. Obesity was not associated with a lower risk of bleeding. The procoagulant profile in obese subjects may not be enough to protect against clinically relevant bleeding. Background Obesity is associated with increased levels of procoagulant factors and decreased fibrinolytic activity. Whether this hemostatic profile protects against clinically relevant bleeding has been scarcely investigated. Objectives To assess the impact of measures of obesity on the risk of bleeding in a large cohort of patients at increased atherothrombotic risk. Methods The Second Manifestation of ARTerial disease (SMART) study included 9736 patients aged 18-79 years, followed for a median of 5.9 years. Body mass index (BMI), waist circumference and hip circumference were measured at inclusion. All incident fatal or non-fatal hemorrhagic events were recorded. Results During follow-up, 359 first bleeding events occurred. In quintile-based analyses, the risk of bleeding was highest in the lowest quintile (Q) of BMI (age and sex-adjusted HR Q2 vs. Q1, 0.68; 95% CI, 0.50-0.94), but there was a threshold effect at low BMI levels (men, < 23.84 kg m(-2) ; women, < 22.49 kg m(-2) ), and the risk estimates for bleeding did not further change across the remaining quintiles (HR Q3 0.81 and Q5 0.75). For waist circumference the relationship appeared to be U-shaped, with the lowest risk of bleeding in quintile 3 (HR Q3 vs. Q1, 0.69; 95% CI, 0.46-1.04). Adjustments for hypertension, hemoglobin level, renal failure, diabetes and use of oral anticoagulants or platelet inhibitors did not affect the results. Conclusion Obesity was not associated with lower risk of bleeding. Our findings suggest that presumed protection against bleeding due to an apparently efficient hemostatic system may be counterbalanced by other factors in obese subjects.

Association between various anthropometric measures of obesity and markers of subclinical atherosclerosis

Central obesity is a known cardiovascular risk factor and measures of visceral obesity are known to predict atherosclerosis. This study sought to explore the association between various anthropometric measures and markers of subclinical atherosclerosis (MoSCA) among low risk healthy individuals. Multi-Ethnic Study of Atherosclerosis (MESA) is a population-based study of Caucasian (38%), Afro-American (28%), Chinese (22%) and Hispanic (12%) subjects, aged 45–84 years, free from clinical cardiovascular disease. We performed a post hoc analysis of the limited access dataset of MESA subjects to evaluate the association between carotid intima media thickness and coronary artery calcium score (CACS), as MoSCA and various measures of obesity. Multivariable regression analyses adjusted for traditional cardiovascular risk factors, ethnicity and C-reactive protein were performed. Each unit increase in waist–hip ratio was strongly associated with increase in both common and internal carotid intima media thickness (beta: 0.12, 95% confidence interval (CI): 0.06 to 0.18, p < 0.001 and beta: 0.23, 95% CI: 0.03 to 0.43, p = 0.021, respectively). Measures of central obesity were superior to body mass index as demonstrated by their consistent association with each category of CACS when compared to the reference category (CACS = 0). Compared to body mass index, measures of visceral obesity were significantly associated with MoSCA in this multiethnic healthy population. Waist–hip ratio seems to be more consistent in its association with various MoSCA compared to other anthropometric measures.

Genetic association studies of obesity in Africa: a systematic review.

Obesity is increasing in Africa, but the underlying genetic background largely remains unknown. We assessed existing evidence on genetic determinants of obesity among populations within Africa. MEDLINE and EMBASE were searched and the bibliographies of retrieved articles were examined. Included studies had to report on the association of a genetic marker with obesity indices and the presence/occurrence of obesity/obesity trait. Data were extracted on study design and characteristics, genetic determinants and effect estimates of associations with obesity indices. According to this data, over 300 polymorphisms in 42 genes have been studied in various population groups within Africa mostly through the candidate gene approach. Polymorphisms in genes such as ACE, ADIPOQ, ADRB2, AGRP, AR, CAPN10, CD36, C7orf31, DRD4, FTO, MC3R, MC4R, SGIP1 and LEP were found to be associated with various measures of obesity. Of the 36 polymorphisms previously validated by genome-wide association studies (GWAS) elsewhere, only FTO and MC4R polymorphisms showed significant associations with obesity in black South Africans, Nigerians and Ghanaians. However, these data are insufficient to establish the true nature of genetic susceptibility to obesity in populations within Africa. There has been recent progress in describing the genetic architecture of obesity among populations within Africa. This effort needs to be sustained via GWAS studies.

Urinary Malondialdehyde Is Associated with Visceral Abdominal Obesity in Middle-Aged Men.

The purpose of the present study was to investigate multiple anthropometric parameters used to evaluate obesity, particularly visceral abdominal fat area, and various metabolic parameters including malondialdehyde (MDA) as an oxidative stress marker. We evaluated various measures of obesity, including body mass index (BMI), waist circumference (WC), sagittal abdominal diameter, fat percentages using dual-energy X-ray absorptiometry, visceral fat area (VFA), subcutaneous fat area, multiple biomarkers related to metabolic disease, and urinary MDA, in 73 asymptomatic middle-aged men who were not severely obese. We examined relationships between multiple measures of obesity, metabolic markers, and urinary MDA levels and evaluated associations between VFA and urinary MDA. In the visceral obesity group, γ-glutamyl transferase (GGT), uric acid, and urinary MDA levels were significantly higher than in the nonvisceral obesity group (P = 0.008, P = 0.002, and P = 0.018). Urinary MDA (r = 0.357, P = 0.002) and uric acid (r = 0.263, P = 0.027) levels were only significantly positively correlated with VFA among measures of obesity. Urinary MDA, serum GGT, and serum CRP were significantly positively associated with VFA (P = 0.001, P = 0.046, and P = 0.023, resp.), even after adjusting for BMI and WC.

Prevalence and association of physical activity with obesity: an urban, community-based, cross-sectional study.

Aim:To study levels of physical activity and various measures of obesity and their association in an urban population.Study Design:Cross sectional.Materials and Methods:One thousand and forty-seven individuals between the ages 25-64 years systematically sampled from a community-based population database were contacted through a house-to-house survey. We adopted the WHO STEPS guidelines for conducting this study. Anthropological measures collected were height, weight, and waist and hip circumference.Results:Physical Activity (PA) levels declined with age and the decline was greater among females. The Pearson's correlation coefficient for age against PA among males was found to be negative and weak (r = –0.104) and that among females was found to be similar (r = –0.206). The prevalence of obesity was higher among females (28.8 %) than among males (13.3 %) and the difference was statistically significant. There was a progressive increase in abdominal obesity with age in both genders. The prevalence of overweight and obesity was higher among individuals with low levels of PA as compared to those with high levels of PA.Conclusion:Sedentary behavior is prevalent in more than half of the current study sample. This was more so with increasing age, female gender and increasing obesity. PA is an important component on long-term weight control, and therefore adequate levels of activity should be prescribed to combat the obesity epidemic. Habitual moderate physical activity may be beneficial in preventing excess accumulation of fat.

Obesity and atrial fibrillation: electroanatomical left atrial remodelling with pronounced changes adjacent to epicardial fat

Background: Obesity is associated with increased risk of atrial fibrillation (AF). The aim of the study was to delineate electrophysiological remodelling and impact of epicardial fat depots on adjacent atrial tissue with obesity. Methods: 112 patients with paroxysmal/persistent AF undergoing AF ablation were screened. After exclusion, 30 patients were enrolled and divided into Obese (BMI≥27) and Control (BMI<27) groups. They underwent cardiac magnetic resonance (CMR) imaging and electro-anatomic mapping of left atrium (LA) prior toAF ablation.Atrial (total and left) and ventricular epicardial fat tissue (EAT)wasdetermined.Global and regional voltage, conduction velocity (CV), fractionation, voltage and CV heterogeneity were determined. Result: The BMI of the obese and control groups was 30.2±2.6 and 25.2±1.3 respectively (p<0.001). Obesity was associated with increase in all measures of EAT (p<0.05). Epicardial fat was distributed adjacent to POS/INF LA. Obesity was associated with reduced global CV (0.86±0.31m/s vs 1.26±0.29; p<0.001) with non-significant increase in conduction heterogeneity (p=0.10) and increased fractionation (54±17% vs 25±10%; p<0.001). Obesity was associated with regional alteration in voltage (p<0.001)with reducedPOSand preserved overall LA voltage, increased low voltage areas (3.4%vs13.9%; p<0.001) predominantly distributed in POS/ INF LA and greater voltage heterogeneity (p=0.001) compared to controls. Amongst various measures of obesity, LA EAT volume correlated best with POS LA CV (p=0.01 vs BMI 0.05). Conclusion: Obesity was associated with marked electroanatomical remodelling of the atria. The remodelling is more pronounced in regions adjacent to epicardial fat depots.

Obesity, Cardiovascular and All-Cause Mortaliy in Chronic Kidney Disease - A Systematic Review and Meta-Analysis.

Background: The role of obesity as a risk factor for premature cardiovascular disease and death in people with chronic kidney disease (CKD) is uncertain due to inconsistent findings across the spectrum of CKD, and among published studies. Aim: Our study aimed to determine the association between obesity measured by body mass index (BMI), waist to hip ratio (WHR) and waist circumference (WC) and risk of death, cardiovascular mortality, and non-fatal cardiovascular events in people with CKD, stratified by stage, and to compare the prognostic strength of the various measures of obesity. Methods: MEDLINE and Embase were searched without language restriction through to May 2013. Hand searches were also conducted. Data were summarised using random effects models where possible. Results: Of the 3413 citations identified, a total of 94 cohorts (n=859,842 participants) assessed the association of one or more measures of obesity and all-cause and cause-specific mortality or cardiovascular outcome in patients with CKD. For every 1 kg/m2 increase in BMI, there was a 3% reduction in all-cause mortality and 4% reduction in cardiovascular mortality in CKD-dialysis (HR 0.97; 95%CI 0.96-0.98 and HR 0.96; 95%CI 0.92-1.00 respectively). In CKD-predialysis, for every 1 kg/m2 increase in BMI there was a 2% reduction in all-cause mortality (HR 0.98; 95%CI 0.0.96-1.00). There were no significant relationship between BMI and mortality in transplanted patients (HR 1.01 95%CI 0.97-1.05). Five cohort studies in total assessed the association between WHR, WC and all-cause mortality but no robust conclusions could be made. Incomplete reporting of prognostic factor and outcome measurement assessment were major limitations of the available studies. Conclusion and Relevance: Pre-dialysis and dialysis patients with a low BMI are at higher risk of mortality and cardiovascular mortality. BMI is not associated with post-transplant mortality. Higher BMI in potential recipients should therefore not preclude this group from consideration for transplantation. Further research is needed to determine if the lack of association between BMI and outcomes in transplanted patients is related to BMI being a poor measure of obesity.

The Impact of Obesity on Risk Factors and Prevalence and Prognosis of Coronary Heart Disease—The Obesity Paradox

Obesity is associated with a host of cardiovascular risk factors and its prevalence is rising rapidly. Despite strong evidence that obesity predisposes to the development and progression of coronary heart disease (CHD), numerous studies have shown an inverse relationship between various measures of obesity (most commonly body mass index) and outcomes in established CHD. In this article we review the evidence surrounding the ≪obesity paradox≫ in the secondary care of CHD patients and the CHD presentations where a paradox has been found. Finally we discuss the impact of cardiorespiratory fitness and a number of mechanisms which may offer potential explanations for this puzzling phenomenon.