Waist Circumference Criteria Research Articles

Association between subjective walking speed and metabolic diseases in individuals with obesity: a cross-sectional analysis

The association between subjective walking speed and metabolic diseases has received limited attention, particularly in individuals with obesity. We aimed to clarify this association using comprehensive health checkup data of participants with obesity. In total, 8578 individuals with a body mass index ≥ 25.0 kg/m2, 9626 individuals with waist circumference ≥ 85 cm in men and ≥ 90 cm in women, and 6742 individuals who met both criteria of body mass index and waist circumference were included in this cross-sectional analysis. Subjective walking speed was investigated using the question “Is your walking speed faster than the speed of those of your age and sex?” in a health examination questionnaire. Metabolic diseases were defined according to the guidelines for each disease, and modified Poisson regression analyses were performed. In the model adjusted for age and sex, individuals with obesity based on body mass index and fast subjective walking speed showed significantly lower risk of diabetes mellitus (risk ratio [RR] 0.70; 95% CI 0.63–0.77) and dyslipidemia (RR 0.97; 95% CI 0.94–1.00). Similarly, among those with obesity based on waist circumference and both body mass index and waist circumference, fast subjective walking speed showed a significant negative association with hypertension (RR 0.94; 95% CI 0.90–0.97 and RR 0.95; 95% CI 0.92–0.99, respectively), diabetes mellitus (RR 0.70; 95% CI 0.64–0.77 and RR 0.70; 95% CI 0.63–0.77, respectively), and dyslipidemia (RR 0.96; 95% CI 0.94–0.99 and RR 0.96; 95% CI 0.94–0.99, respectively). Thus, among individuals with obesity, the odds of metabolic diseases were lower if their subjective walking speed was fast. This study contributes to earlier prevention of the cascade of diseases that begin with obesity.

Association between intuitive eating and health outcomes in outpatients with type 2 diabetes: a cross-sectional study.

To evaluate the association between intuitive eating and health outcomes in patients with type 2 diabetes in a cross-sectional study. Consecutively, outpatients attending at university hospital underwent clinical, laboratory, lifestyle, and eating behavior evaluations. Intuitive eating was assessed using the Intuitive Eating Scale-2 (IES-2), and the Three Factor Eating Questionnaire-21 was adopted as a confirmatory tool for disordered eating behavior. Optimized health outcomes were considered according to the American Diabetes Association criteria for BMI, HbA1c, lipid profile, and blood pressure values, and the International Diabetes Federation criteria for waist circumference. Considering the answers of the IES-2 items, patients were grouped by latent class analysis, and their characteristics were compared by appropriate tests. In total, 267 patients were evaluated: 62.2% women, with 60 (53-65) years, BMI 31.9 ± 5.4kg/m², diabetes duration of 16 ± 9 years, HbA1c 8.5 ± 1.5%, and an IES-2 total score of 58 (50-67)%. Three intuitive eating groups were identified: higher intuitive eating, nonemotional-oriented coping, and lower intuitive eating. Patients with higher intuitive eating have higher chances of having optimized BMI and serum triglycerides values compared to patients with lower intuitive eating. Also, the 10-point increase on IES-2 was associated with a 0.62kg/m² reduction on BMI values (95%CI -1.18;-0.06), 1.90cm on waist circumference (95%CI -3.26;-0.54), and 23mg/dL in serum triglycerides values (95%CI -38.27;-7.40) after adjustment for age, sex, psychotropic drug use, medication effect score, smoking, and BMI. Intuitive eating seems to be associated with optimized health outcomes and may contribute to better personalized interventions in nutritional treatment that promote adaptive behaviors in diabetes management, but should be tested.

Concordance between metabolic dysfunction-associated steatotic liver disease and nonalcoholic fatty liver disease.

A multisociety consensus group proposed a new nomenclature for metabolic dysfunction-associated steatotic liver disease (MASLD). Although patients with nonalcoholic fatty liver disease (NAFLD) are expected to be reclassified as patients with MASLD under the new nomenclature, the concordance between MASLD and NAFLD remains unclear. Moreover, waist circumference could be adjusted by ethnicity for diagnosing MASLD; however, there are limited data on the optimal waist circumference in the Japanese population. This cross-sectional study was conducted on 3709 Japanese patients with NAFLD. The primary endpoint was the prevalence of MASLD in patients with NAFLD. The difference between the original waist circumference criteria (>94cm for men and >80cm for women) and the Japanese metabolic syndrome criteria (≥85cm for men and ≥90cm for women) for concordance between NAFLD and MASLD was also investigated. According to the original criteria, the prevalence of MASLD in patients with NAFLD was 96.7%. Similarly, according to the Japanese waist circumference criteria, 96.2% of patients with NAFLD could be reclassified as those with MASLD. The concordance rate was significantly higher in the original criteria than in the Japanese criteria (p=0.02). NAFLD could be considered MASLD using the original MASLD criteria in the Japanese population, and insights from NAFLD research could be applied to MASLD.

Lean Metabolic Syndrome vis-à-vis Obese Metabolic Syndrome: Observations from an Eastern Indian Tertiary Set-up

Background: Metabolic syndrome (MetS) in obese is a fairly common entity. However, excluding the waist circumference (WC) criteria, other components of the MetS are also seen in lean or nonobese people. Our study aimed to determine the prevalence of lean MetS among newly diagnosed MetS cases and compare the biochemical parameters and insulin resistance in lean versus overweight/obese MetS. Methods: A cross-sectional, observational study was conducted over 12 months and included adult patients of either sex, newly diagnosed with MetS. Fever cases, infections such as tuberculosis/HIV/chronic infectious disease, chronic inflammatory diseases, those having endocrine causes of obesity such as Cushing syndrome, known cases of ischemic heart disease, and those on antiobesity medications were excluded. Diagnosed MetS patients were categorized as lean or obese based on the standard criteria. A convenient sample of 50 was considered for either group (lean MetS vs. obese MetS). Included patients were investigated for lipid, liver, glycemic, and insulin resistance profiles. Other parameters included serum uric acid, thyroid function, whole abdomen ultrasound, electrocardiography, two-dimensional echocardiography (ECHO), fibroscan, and polysomnography for obstructive sleep apnea (OSA). Results: The prevalence of lean MetS was 9.87%. Variables such as body mass index, WC, low-density lipoprotein, and systolic blood pressure were significantly higher in the obese MetS in comparison to the lean MetS group. Fasting insulin was also significantly higher in the obese MetS compared to lean MetS. Biochemical measures such as aspartate aminotransferase and alanine transferase were significantly higher for the obese MetS, while the change was nonsignificant for other biochemical measures. Except for complications such as polycystic ovary syndrome, acanthoses nigricans, and gallstones which were significantly higher in the obese MetS group, the rest of the complications were similar in both groups. Conclusion: MetS among nonobese or lean subjects differs in certain aspects from those with obesity. As lean MetS is an emerging entity, clinicians must be aware of it to avoid morbidity.

Interactive associations of smoking and physical activity with metabolic syndrome in adult men in Korea.

This study aimed to investigate the association of smoking and physical activity (PA) with metabolic syndrome (MetS) in adult men in Korea. This study analyzed data of 7,229 adult men aged 19-64 years obtained from the 2014-2021 Korea National Health and Nutrition Examination Survey (KNHANES). Information on smoking habits was obtained using KNHANES data, while that on total PA (TPA), leisure-time PA (LTPA), and occupational PA (OPA) was collected using the Global Physical Activity Questionnaire. Smoking status was classified into non-smokers and smokers, and PA was categorized into three groups (total, leisure time, and occupational) according to the time spent engaging in moderate or high-intensity PA areas. The diagnosis of MetS was based on the Adult Treatment Program III of the National Cholesterol Education Program and Koreans' waist circumference criteria. Logistic regression revealed that the risk of MetS was significantly lower in non-smokers than in smokers, even after adjusting for all covariates. The risk of MetS was significantly lower in individuals who engaged in at least 150 min of moderate- and high-intensity TPA or LTPA per week than in those who did not engage in PA. Furthermore, smokers who engaged in at least 150 min of moderate- to high-intensity TPA and LTPA per week had a significantly lower risk of MetS than those who did not engage in PA. Meanwhile, OPA was not associated with MetS. The findings suggest that engaging in moderate- to high-intensity TPA or LTPA for at least 150 min per week attenuates the risk of MetS caused by smoking.

Effects of Obesity Type on Diabetes and Hypertension in Obese Korean Adults

Obesity is a major cause of diabetes and hypertension. Previous studies have analyzed the effects of obesity on diabetes and hypertension by comparing non-obese and obese groups. Here, we investigated the effects of obesity type through comparison between obesity types in obese adults.The sample comprised 8,914 adults, classified as obese according to body mass index criteria or waist circumference criteria, selected from the Korean National Health and Nutrition Examination Survey (2016-2020). Obesity was classified as abdominal obesity-only, general obesity-only, and abdominal and general obesity. The effects of obesity type on diabetes and hypertension were analyzed using logistic regression model.12.78% of participants exhibited abdominal obesity-only, 22.35% had general obesity-only, and 64.78% had both types. The proportion of patients aged ≥60 years was 57.52% in the abdominal obesity-only group, while 17.12% in the general obesity-only group. The general obesity-only group had a lower incidence of diabetes than the abdominal obesity-only group (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.47-0.77), and the abdominal and general obesity group had a higher incidence of hypertension than the abdominal obesity-only group (OR, 1.82; 95% CI, 1.54-2.15).Abdominal obesity has a stronger association with diabetes than general obesity, and the risk of hypertension is greatest when both obesity types coexist. Individuals with abdominal obesity-only are likely to be excluded from obesity management, especially when aged ≥60 years. The risk of hypertension is much greater when abdominal and general obesity coexist, emphasizing the need to use both body mass index and waist circumference to define obesity.

Sex-Related Differential Prevalence of Central Obesity in Diabetes Mellitus: A Multi-centred Survey in North-Central Nigeria

Background: Contrary to the old dictum that central obesity is more common among men than women, recent reports have shown a gradual reversal of this trend, as suggested by some studies. Objective: To compare the prevalence of central obesity among men and women with Diabetes mellitus in North-Central Nigeria. Methods: This multi-centred, cross-sectional study was conducted across 20 hospitals in Abuja, Nasarawa State, and Niger State, involving 1040 participants. Some obesity indices (body mass index, waist circumference and waist-to-height ratio) were measured. Results: The prevalence of central obesity (waist circumference criterion) was significantly higher in the females compared to male participants (89.6% vs 51.6%, χ2 = 1231.37, p<0.001), similar to the prevalence determined by waist-height ratio criterion (female vs male, 88.8% vs 71.5%, χ2 = 58.83, p<0.001). Following correction for age, duration of diabetes mellitus, blood pressure, blood glucose, and glycated haemoglobin using logistic regression, female gender remained a significant determinant of central obesity (OR = 2.76, 95% CI 1.81-3.83, p = 0.004). Conclusion: The prevalence of central obesity was higher among women than men in a cross-section of patients with diabetes mellitus in North-Central Nigeria.

Heavy metal exposure linked to metabolic syndrome in Korean male firefighters: FRESH cohort cross-sectional analysis

This study aimed to identify the relationship between blood lead and Cadmium (Cd) concentrations and metabolic syndromes (MetS), including its components (central obesity, hypertriglyceridemia, low high-density lioioritein, hypertension, and hyperglycemia) among Korean firefighters. A total of 965 firefighters of the Enhancement of Safety and Health cohort were analyzed in this study. MetS was defined according to the 2005 revised National Cholesterol Education Program-Adult Treatment Panel III criteria and the Korean Society for the Study of Obesity criteria for waist circumference. The collected data were analyzed using a logistic regression model. Of the 965 participants, 190 (19.7%) had MetS. After adjusting for age, body mass index, smoking, drinking, exercise, shift duty, and main duty position, the Cd level was significantly associated with an increased risk of MetS in the Korean firefighter population (odds ratio [OR] = 1.62, 95% confidence interval [CI] 1.07, 2.46). This association was significant among non-smokers and ex-smokers (OR = 1.58, 95% CI 1.03, 2.43), non-drinkers and ex-drinkers (OR = 1.77, 95% CI 1.06, 2.94), firefighters aged 40 year or older (OR = 1.77, 95% CI 1.10, 2.86), and office administrators (OR = 3.85, 95% CI 1.42, 10.39). This outcome suggests that exposure to Cd is likely to increase risk of MetS among firefighters.

#3841 ASSOCIATION BETWEEN BODY MASS INDEX, WAIST CIRCUMFERENCE AND CLINICAL OUTCOMES IN KOREAN ADVANCED CHRONIC KIDNEY DISEASE PATIENTS

Abstract Background and Aims This study analysed the association between body mass index (BMI) and waist circumference (WC) with all-cause death, 3-point major cardiovascular event (MACE), end-stage kidney disease (ESKD) and total composite events in nation-wide cohort of Korean advanced chronic kidney disease (CKD) patients. Method This nationwide cohort study, using the National Health Insurance Database, included adult health examinees who received two or more check-ups from 2009 to 2012. Among them, CKD patients (N = 325,657, stage G3a, G3b and 4) were identified. Patients were classified into three groups for BMI (<18.5, 18.5-25 [reference] and ≥25) and four groups for WC (female; <75 cm or male; <85 cm [WC1], female; 75 cm≤WC<85 cm or male; 85 cm≤WC<95 cm [reference], female; 85 cm≤WC<95 cm, male; 95 cm≤WC<105 cm [WC2] and female; ≥95 cm, male; ≥105 cm [WC3]). Risks were evaluated using Cox proportional hazard analysis. Results Patients (58.6±7.7 years) had mean eGFR of 54.32±5.83ml/min/1.73 m2. The underweight (BMI<18.5) group had increased risks of death [HR 1.757, 95% CI (1.573-1.964)] and total events [HR 1.244, (1.144-1.353)]. Overweight (BMI≥25) group showed lower risks of death [HR 0.888, (0.86-0.917)], ESKD [HR 0.855, (0.788-0.927)] and total events [HR 0.975, (0.956-0.995)]. However, the risk was increased for 3-point MACE [HR 1.056, (1.031-1.081)]. For the association between WC and clinical outcomes, the low WC group (WC1) had increased risk of death [HR 1.129, (1.089-1.17)] and reduced risk for 3-point MACE [HR 0.92, (0.894-0.947)]. In higher WC groups, increased risks were observed for death [WC2: HR 1.052, (1.008-1.098), WC3: HR 1.32, (1.213-1.437)], 3-point MACE [WC2: HR 1.071, (1.038-1.104), WC3: HR 1.104, (1.036-1.176)] and total events [WC2: HR 1.049, (1.022-1.077), WC3: HR 1.12, (1.062-1.181)]. Conclusion In CKD patients, both lower BMI and WC were risk factors for mortality and ESKD. However, compared to the reference group, higher BMI group exhibited better outcomes while higher WC groups exhibited poorer outcomes. As increased WC is more specifically related to central obesity, we need different approaches to interpreting clinical risks associated with different BMI and WC criteria.

Obesity Prevalence Among Older People in Tabriz, Iran: Data from Health Status of Aged People in Tabriz (HSA-T) Study

Objectives: To estimate the obesity prevalence in a representative sample of community-dwelling older adults in Tabriz, Iran. Design: Cross-sectional study. Setting(s): Tabriz, the capital of East Azerbaijan Province, Iran. Participants: A representative sample of 1071 (514 males and 557 females) community-dwelling older adults aged≥60 years were selected using the probability proportional to size (PPS) sampling method. Then, anthropometric measures were conducted on 1041 subjects (506 males and 535 females). Outcome Measures: Anthropometric measures including weight, height, body mass index (BMI), hip circumference (HC), waist circumference (WC), and waist-to-hip ratio (WHpR) were conducted and used for the evaluation of overweight and obesity. Obesity was determined according to traditional BMI classifications and population-appropriate WC criterion cut-offs for the estimation of central adiposity. Results: The prevalence of overweight and obesity was 37.4%, 95% CI: 34.5 to 40.4 and 34.3%, 95% CI: 31.4 to 37.3, respectively. Obesity was more prevalent in females (46.6%, 95% CI: 36.9 to 57.2) than in males (21.2, 95% CI: 13.5 to 30.3), but the overweight prevalence was greater in males. Moreover, mean BMI was lower in males than in females (26.9±4.2 kg/ m2 vs. 29.9±6.0 kg/m2 ; P<0.001) and significantly decreased with increasing age. Similarly, mean WC was lower in males than in females (99.7±13.6 cm vs. 102.3±14.3 cm; P=0.002) and decreased significantly with age. Conclusions: The high prevalence of obesity in older people highlights the necessity of designing effective healthy lifestyle interventions and national policies to focus on dietary modification and lifestyle changes and promote physical activity to reduce obesity in aged people, particularly in older Iranian women.

Malnutrition and Insulin Resistance May Interact with Metabolic Syndrome in Prevalent Hemodialysis Patients

We sought to determine the prevalence of metabolic syndrome (Mets) and whether 100 cm2 of visceral fatty area (VFA) measured by computed tomography (CT) validates the criteria of waist circumference (WC) in hemodialysis (HD) patients. The study comprised 141 HD patients. Mets was defined according to the criteria of Adult Treatment Panel III (ATP III) and the modified criteria of National Cholesterol Education Program (NCEP) that defines abdominal obesity as a WC of >=85 cm in men and >=90 cm in women. The prevalence of Mets was 31.9% in men and 13.6% in women. However, the prevalence of patients with a body mass index over 25 in all HD patients was only 11.2%. The visceral fatty area (VFA) measured by CT showed a strong positive correlation with WC. The patients with Mets, comparing with those without Mets, have significantly shorter duration of HD, higher high-sensitive C-reactive protein, and higher Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). In the patients with Mets, there was a significant negative correlation between HOMA-IR and serum albumin levels. Multivariate logistic regression analysis showed that HOMA-IR and short duration of HD were chosen as independent risk factors for Mets. Mets is more prevalent in HD patients. In Japanese HD patients, 100 cm2 of VFA corresponded to a WC of 85 cm in men and 90 cm in women, thus confirming the validity of the modified criteria. HOMA-IR and serum albumin were significantly correlated in HD patients with Mets.

Association between Vitamin B and Obesity in Middle-Aged and Older Chinese Adults.

Previous studies have found that obese people have lower levels of vitamin B, but most have focused on obesity as defined by body mass index (BMI), and its relationship with other types of obesity is unclear. The aim of this study was to explore the relationship between vitamin B levels and obesity assessed by different definitions among Chinese middle-aged and older community-dwelling adults. This cross-sectional study included 887 participants aged 45 years and older (45-82 years). The concentrations of vitamin B (B1, B2, B6, and B9) were measured by robotic dry blood spot extraction systems in combination with liquid chromatography-tandem mass spectrometry. BMI, body fat percentage (BF%), visceral fat area (VFA), and waist circumference (WC) were used to diagnose obesity. VFA and BF% were assessed by bioelectrical impedance analysis. The logistic regression model was used to assess the associations between vitamin B levels and the odds of obesity. The average age of all participants was 60.77 (SD 6.33) years. The prevalence of obesity varied from 8.6% to 52.4% depending on different diagnostic criteria. After adjusting for covariates, a negative correlation was observed between vitamin B1 level and obesity according to the criteria of WC, VFA, and BF%, and the adjusted odds ratio (OR) was 0.47, 0.52, and 0.46, respectively. When using WC and BF% to define obesity, higher quartiles of vitamin B2 were negatively associated with the odds of obesity (OR: 0.62 and 0.62, respectively). Vitamin B6 was inversely associated with VFA-defined and BF%-defined obesity (OR: 0.64 and 0.64, respectively). When using VFA and BF% to define obesity, a negative correlation was observed in vitamin B9 (OR: 0.61 and 0.67, respectively). Vitamin B (B1, B2, B6, and B9) level was negatively related to obesity (defined by WC, VFA, or BF%) in Chinese middle-aged and older adults.

Relationships Of Metabolic Syndrome And Cardiorespiratory Fitness With Cognitive Impairment In Korean Older Adults

Metabolic syndrome (Mets), which refers to a clustering of central obesity, increased resting blood pressure, increased fasting glucose, increased triglycerides and decreased high-density lipoprotein cholesterol, is associated with an increased risk for cardiovascular diseases and mental health conditions including cognitive decline. Poor cardiorespiratory fitness (CRF) is another-established risk factor for the health conditions. PURPOSE: The purpose of this study was to examine the relationships of MetS and CRF with cognitive impairments in Korean older adults. METHODS: Study participants were community dwelling Korean older adults (n = 509/82% women) aged 60-89 years. Mets was defined according to the Asian waist circumference criteria based on the National Cholesterol Education Program Adult Treatment Panel III criteria. CRF was measured using a submaximal exercise 6-minute walking test. Cognitive impairment was assessed with the Mini-Mental State Examination for Dementia Screening of Korean version (MMSE-KC). Cognitive impairment was defined as an MMSE-KC score of <1.5 standard deviations from the age-, sex-, and education-adjusted norm for older Koreans. Multivariate logistic regression analysis was used to assess the relationships of Mets and CRF with cognitive impairment at p = 0.05 with the SPSS-PC software (version 27.0). RESULTS: The prevalence of cognitive impairment was 23.4% in total, with 14.0% in men and 25.5% in women. Compared to no Mets plus normal CRF, the risk for cognitive impairment was incremental from Mets only (OR (95% CI) = 1.747 (1.044-2.923), p = 0.043) to low CRF only (OR (95% CI) = 2.246 (1.146-4.402), p = 0.018) and Mets plus low CRF (OR (95% CI) = 3.066 (1.711-5.492), p < 0.001). CONCLUSIONS: The current findings of the study suggest an individual and synergistic effects of Mets and low CRF on cognitive impairments in Korean older adults. Supported by the National ResearchFoundation funded by the Korea Government (NRF-2018R1D1A1B07048210 & 2020S1A5B5A16084067).

Association between metabolically healthy obesity and non-alcoholic fatty liver disease.

The risks of NAFLD and NAFLD with fibrosis progression among metabolically healthy obesity (MHO) individuals are largely unexplored. This cohort study investigated the association between MHO as well as other metabolic syndrome-obesity combined phenotypes and NAFLD and its fibrosis progression. Participants included 31,010 adults from a health check-up cohort free from NAFLD and intermediate or high probability of advanced fibrosis at baseline. Metabolically healthy was defined as not having any component of metabolic syndrome. Obesity was identified by body mass index (BMI) and waist circumference (WC). Participants were cross-classified by metabolic health and obesity at baseline. The outcomes were NAFLD, and NAFLD with fibrosis progression, as assessed by abdominal B-type ultrasound and noninvasive fibrosis score. During a median follow-up of 2.2 (interquartile range, 1.2-4.9) years, 7,393 participants developed NAFLD. MHO individuals (HR 5.51, 95% CI 4.98, 6.09 for BMI criteria; HR 6.76, 95% CI 6.04, 7.57 for WC criteria) had a significantly higher risk of NAFLD than those with metabolically healthy normal weight or low WC. The corresponding HRs (95% CIs) for metabolically healthy overweight (defined by BMI) and medium WC were 2.74 (2.49-3.02) and 2.93 (2.65-3.24), respectively. Furthermore, 557 participants developed NAFLD with fibrosis progression. The association between different obesity phenotypes and NAFLD with fibrosis progression also showed a similar pattern. MHO was associated with significantly higher risks of NAFLD and its fibrosis progression, suggesting that regarding NAFLD prevention, MHO individuals might still benefit from lifestyle interventions aimed at body weight and WC maintenance.

Abdominal obesity phenotypes are associated with the risk of developing non-alcoholic fatty liver disease: insights from the general population

BackgroundThe diversity of obesity-related metabolic characteristics generates different obesity phenotypes and corresponding metabolic diseases. This study aims to explore the correlation of different abdominal obesity phenotypes with non-alcoholic fatty liver disease (NAFLD).MethodsThe current study included 14,251 subjects, 7411 males and 6840 females. Abdominal obesity was defined as waist circumference ≥ 85 cm in males and ≥ 80 cm in females; according to the diagnostic criteria for metabolic syndrome recommended by the National Cholesterol Education Program Adult Treatment Panel III, having more than one metabolic abnormality (except waist circumference criteria) was defined as metabolically unhealthy. All subjects were divided into 4 abdominal obesity phenotypes based on the presence ( +) or absence (− ) of metabolically healthy/unhealthy (MH) and abdominal obesity (AO) at baseline: metabolically healthy + non-abdominal obesity (MH−AO−); metabolically healthy + abdominal obesity (MH−AO+); metabolically unhealthy + non-abdominal obesity (MH+AO−); metabolically unhealthy + abdominal obesity (MH+AO+). The relationship between each phenotype and NAFLD was analyzed using multivariate logistic regression.ResultsA total of 2507 (17.59%) subjects in this study were diagnosed with NAFLD. The prevalence rates of NAFLD in female subjects with MH−AO−, MH−AO+, MH+AO−, and MH+AO+ phenotypes were 1.73%, 24.42%, 7.60%, and 59.35%, respectively. Among male subjects with MH−AO−, MH−AO+, MH+AO−, and MH+AO+ phenotypes, the prevalence rates were 9.93%, 50.54%, 25.49%, and 73.22%, respectively. After fully adjusting for confounding factors, with the MH−AO− phenotype as the reference phenotype, male MH−AO+ and MH+AO+ phenotypes increased the risk of NAFLD by 42% and 47%, respectively (MH−AO+: OR 1.42, 95%CI 1.13,1.78; MH+AO+: OR 1.47, 95%CI 1.08,2.01); the corresponding risks of MH−AO+ and MH+AO+ in females increased by 113% and 134%, respectively (MH−AO+: OR 2.13, 95%CI 1.47,3.09; MH+AO+: OR 2.34, 95%CI 1.32,4.17); by contrast, there was no significant increase in the risk of NAFLD in the MH+AO− phenotype in both sexes.ConclusionsThis first report on the relationship of abdominal obesity phenotypes with NAFLD showed that both MH−AO+ and MH+AO+ phenotypes were associated with a higher risk of NAFLD, especially in the female population. These data provided a new reference for the screening and prevention of NAFLD.

Prevalence of metabolic syndrome in a Russian population: The Ural Eye and Medical Study and the Ural Very Old Study

PurposeTo examine prevalence and associated factors of the metabolic syndrome (MS) in populations in Russia. MethodsTwo population-based studies (Ural Eye and Medical Study (UEMS), Ural Very Old Study (UVOS)) were conducted in rural and urban regions in Bashkortostan/Russia and included participants aged 40+ years and 85+ years, respectively. ResultsOut of 5895 UEMS participants, 1572 individuals had MS (prevalence:26.7%; 95% confidence interval (CI):25.5,27.8). The criteria of waist circumference, blood pressure, hyperglycemia, serum high-density lipoprotein concentration and serum triglyceride concentration were fulfilled by 4269 (72.4%; 95%CI:71.3,73.6), 3168 (53.7%; 95%CI:52.5,55.1), 1375 (23.3%; 95%CI:22.4,24.6), 712 (13.3%; 95%CI:12.4,14.2), and 1527 (28.6%; 95%CI:27.4,29.8) individuals, respectively. Higher MS prevalence was associated with older age (odds ratio (OR):1.03; 95%CI:1.02,1.04;P < 0.001), female sex (OR:1.93; 95%CI:1.51,2.47;P < 0.001), higher body height (OR:1.03; 95%CI:1.01,1.04;P < 0.001), Russian ethnicity (OR:1.38; 95%CI:1.13,1.70;P = 0.002), lower ankle-brachial index (OR:0.19; 95%CI:0.11,0.30;P < 0.001), higher prevalence of lower backache (OR:1.29; 95%CI:1.08,1.52;P = 0.004), cardiovascular disease (OR:2.32; 95%CI:1.92,2.78;P < 0.001) and thyroid disease (OR:1.41; 95%CI:1.04,1.92;P = 0.03), lower international normalized ratio (OR:0.55; 95%CI:0.32,0.95;P = 0.03), lower prevalence of current smoking (OR:0.67; 95%CI:0.50,0.89;P = 0.006), and higher prevalence of alcohol consumption (OR:1.35; 95%CI:1.11,1.64;P = 0.003). Out of 1124 UVOS participants (age:88.2 ± 2.7 years; range:85–100 years), MS was present in 485 individuals (prevalence:43.1%; 95%CI:40.3,46.1). The criteria of waist circumference, blood pressure, hyperglycemia, serum high-density lipoprotein concentration and serum triglyceride concentration were fulfilled by 853 (75.9%; 95%CI:73.4,78.4), 1057 (94.0%; 95%CI:92.7,95.4), 320 (26.9%; 95%CI:24.3,29.5), 525 (46.7%; 95%CI:43.8,49.6), and 337 (30.0%; 95%CI:27.3,32.7, individuals, respectively. Higher MS prevalence was associated with female sex (OR:2.30; 95%CI:1.72,3.09;P < 0.001) and higher serum concentration of aspartate transaminase (OR:1.02; 95%CI:1.01,1.03;P = 0.007). ConclusionsMS is common in Russia, increases with age up to about 70 years and then plateaus, is more common in women, and differs in its associated factors between middle-aged and very old populations.

Metabolically healthy obesity was significantly associated with increased risk of gallstones.

The risk of gallstones among metabolically healthy obesity (MHO) individuals is largely unexplored. Therefore, the present study investigated the association between MHO and gallstones in a health check-up cohort of Chinese adults. A prospective cohort study. Participants included 58 862 individuals from the MJ health check-up cohort aged ≥ 18 years without a history of gallstones at baseline. Gallstones were diagnosed using abdominal B-type ultrasound. Metabolically healthy was defined as not having any one of the components of metabolic syndrome. Obesity was identified by BMI and waist circumference (WC). Participants were cross-classified at baseline by metabolic health and obesity. Adjusted hazard ratios (HRs) and 95% CIs of gallstones across BMI or WC categories were estimated with Cox proportional hazard regression models. During a median follow-up of 3.0 years (interquartile range, 1.6-6.1), 1269 participants developed gallstones. Individuals with MHO (HR: 1.95, 95% CI: 1.23, 3.09 for BMI criteria; HR: 1.74, 95% CI: 1.37, 2.21 for WC criteria) had a significantly higher risk of gallstones than those with metabolically healthy normal weight. In metabolically healthy individuals, BMI and WC both displayed linear dose-response relationships with gallstones (P for non-linearity >0.05). The association between MHO and gallstones remained unchanged when using different criteria for metabolic health and obesity. MHO was significantly associated with gallstones, suggesting that obesity can independently contribute to gallstones development, even among metabolically healthy individuals. These findings emphasize that metabolically healthy individuals may still benefit from maintaining normal body weight to prevent gallstones.

Гендерные и возрастные особенности связи антропометрических параметров ожирения с нарушениями липидного обмена

Гендерные и возрастные особенности связи антропометрических параметров ожирения с нарушениями липидного обмена

Transitions in metabolic health status over time and risk of heart failure: A prospective study

Aims- Evidence for the effects of metabolically healthy obese (MHO) status on heart failure (HF) is limited and ignores the dynamic change of metabolic health and obesity phenotypes. We aimed to investigate the associations of metabolic health and its transition with HF across body mass index (BMI) and waist circumference (WC) categories. Methods- This prospective cohort study was conducted with 93,288 Chinese adults who were free of cardiovascular disease, cancer or HF at baseline (2006–2007). Metabolic health was defined as having no or only one abnormality in blood pressure, glucose, high-density lipoprotein cholesterol, or triglyceride levels. Participants were cross-classified at baseline by metabolic health and obesity (defined by BMI and WC criteria). Transitions in metabolic health status from 2006 to 2007 to 2010 to 2011 were considered. The hazard ratios (HRs) and 95% confidence intervals (CIs) for HF were assessed by Cox proportional hazards regression. Results- During a mean ± standard deviation follow-up of 9.7 ± 1.5 years, 1,628 participants developed HF. Individuals with MHO (HR: 1.78, 95% CI: 1.45, 2.19 for BMI criteria; HR: 1.51, 95% CI: 1.30, 1.76 for WC criteria) had higher risk of HF than those with metabolically healthy normal weight (MHNW). Individuals with initial MHO who shifted to metabolically unhealthy phenotype during follow-up had higher risk of HF compared with stable MHNW individuals (HR 3.12; 95% CI: 2.01, 4.85 for BMI categories; HR 1.98; 95% CI: 1.42, 2.77 for WC categories). Even stable MHO individuals were at an increased risk of HF compared with stable MHNW individuals (HR: 2.17; 95% CI: 1.39, 3.39 for BMI categories; HR: 1.33; 95% CI: 0.96, 1.85 for WC categories). Conclusions- MHO phenotype is dynamic and its transition to metabolically unhealthy phenotype or even stable MHO is associated with increased risk of HF. Maintaining metabolic health may provide a clue for preventing HF.

Visceral Adiposity Index and its Correlation with other Anthropometric Indicators of Obesity in a group of Bangladeshi Patients with Acute Coronary Syndrome

Background: The visceral adiposity index (VAI) is proposed as a substitute marker of dysfunction and distribution of adipose tissue and is found to be independently correlated with cardiometabolic risk associated with visceral obesity. However, VAI is not well studied in Bangladeshi population. Objectives: This study was aimed to determine the visceral adipose dysfunction (VAD) based on VAI in a group of patients with Acute Coronary Syndrome (ACS) admitted in a tertiary care hospital of Bangladesh and also to determine the correlation of VAI with other anthropometric indicators of obesity. Methods: This descriptive cross-sectional study was conducted on 96 admitted patients of ACS at the Department of Cardiology, Abdul Malek Ukil Medical College &amp; Hospital, Noakhali, Bangladesh from January 2019 to June 2019. Fasting serum lipid profile was obtained within 24 hours of hospitalization and demographic and anthropometric parameters [Body Mass Index (BMI), Waist Circumference (WC) and Waist to Height Ratio (WHtR)] were documented. VAI was calculated and VAD was determined for each patients. Results: The mean age of the subjects were 57.7±14.4 years with majority (71.9%) being male. Based on BMI 50% patients were obese. 69.8% and 81.3% had central obesity based on WC and WHtR criteria respectively. Overall, mean VAI was high (7.48±2.85) and significantly higher in female than male (8.83±2.89 versus 6.95±2.67; p=0.003). All patients had VAD. WHtR had significant positive correlation with VAI (r=0.338; p=0.001). Conclusion: VAD was highly prevalent in this group of ACS patients and WHtR was better than WC and BMI to measure the visceral fat.