Male Waist Circumference Research Articles

Central adiposity is significantly higher in female compared to male in Pakistani type 2 diabetes mellitus patients.

Background:Type 2 diabetes mellitus (DM) rates are increasing rapidly in South Asians. Cardiovascular complications are more frequent and occur earlier in our patients than patients in many other ethnic groups. Reasons for this are not fully understood.Aims:The aim of this study is to evaluate the body total and central fat percentage in type 2 Diabetes Mellitus patients and to check correlation with BMI, waist circumference and metabolic profile.Settings and Design:A cross-sectional study conducted at endocrine clinic, Aga Khan University Hospital Karachi, Pakistan, from May to December 2012.Materials and Methods:Patients of either gender with type 2 diabetes mellitus were randomly selected. A separate proforma for each patient was recorded for demographics, risk factors, bioelectrical impedance measurement for body fat and investigations.Statistical Analysis:Correlation between body fat and other covariate were compared by Pearson correlation coefficient test. A P < 0.05 was considered significant. SPSS19.0 was used to analyze the data.Results:One hundred and seventy five patients (95 male and 80 female) with mean age of 54.1 ± 12 years were evaluated. Mean duration of diabetes was 8.1 years, mean HbA1c was 8.1% and 53.7% were on oral agents and rest were on insulin with or without oral agents. Hypertension was present in 65.7%, 13.7% had known coronary artery disease and 2.3% had cerebrovascular disease. Mean BMI in males was 29.1 ± 4.74 kg/m2 and females 31.7 ± 5.3 kg/m2. Mean waist circumference in males was 107.3 ± 16.6 cm and 103 ± 12 cm in females. Total body fat percentage (%BF) in males was 30.9 ± 7.1% and females 40 ± 8.2% with 89% of the total cohort having total body fat percentage above the normal, less than 25% central fat percentage was 13.3 ± 5.2% in males and 14.6 ± 5.5% in females with 79.4% of cohort having increased central fat (normal <9%). Total and central body fat correlated with BMI (r = 0.68, P < 0.001) and waist circumference (r = 0.66, P < 0.001) but not with HbA1c, triglyceride level or with fasting or random blood glucose levels. Women had significantly higher total body fat percentage compared to men (P < 0.001) although central fat percentage was similar in both sexes.Conclusions:High body fat percentage, waist circumference are seen especially in woman and central body fat percentage in both sexes among patients with type 2 diabetes mellitus in Pakistan. Body fat percentage should be measured and followed as this may be an important contributing factor to the high macrovascular complication rate in this part of world.

Sensitivity and specificity of different measures of adiposity to distinguish between low/high motor coordination

ObjectiveThis study aimed to determine the ability of different measures of adiposity to discriminate between low/high motor coordination and to evaluate the relationship between different measures of adiposity and motor coordination. MethodsThis study included 596 elementary school children aged 9 to 12 years (218 females – 47.1%). Weight, height, and waist circumference were objectively measured by standardized protocols. Body fat percentage was estimated by bioelectric impedance. Body mass index and waist‐to‐height ratio were computed. Motor coordination was assessed by the Körperkoordination Test für Kinder. Cardiorespiratory fitness was predicted by a maximal multistage 20 m shuttle‐run test of the Fitnessgram Test Battery. A questionnaire was used to assess the maternal educational level. ResultsThe receiver operating characteristic performance of body fat percentage in females and waist circumference in males presented a slightly better discriminatory accuracy than body mass index, waist circumference and waist‐to‐height ratio in predicting low motor coordination. After adjustments, logistic regression analyses showed that body mass index (β=2.155; 95% CI: 1.164‐3.992; p=0.015 for girls; β=3.255; 95% CI: 1.740‐6.088; p<0.001 for males), waist circumference (β=2.489; 95% CI: 1.242‐4.988; p=0.010 for girls; β=3.296; 95% CI: 1.784‐6.090; p<0.001 for males), body fat percentage (β=2.395; 95% CI: 1.234‐4.646; p=0.010 for girls; β=2.603; 95% CI: 1.462‐4.634; p<0.001 for males) and waist‐to‐height ratio (β=3.840; 95% CI: 2.025‐7.283; p<0.001 for males) were positively and significantly associated with motor coordination in both sexes, with the exception of waist‐to‐height ratio in girls (β=1.343; 95% CI: 0.713‐2.528; p=0.381). ConclusionBody fat percentage and waist circumference showed a slightly better discriminatory accuracy in predicting low motor coordination for females and for males, respectively.

Survey of the relationship between metabolic syndrome and myocardial infarction in hospitals of Urmia University of medical sciences.

Background and Aim:The aim of this study was to determine the relationship between metabolic syndrome and myocardial infarction in patients admitted to the hospitals of Urmia University of medical sciences.Methods:A case-control study population consisted of 172 patients with heart failure who were admitted to Seyedolshohada Hospital. In this method, the researchers present in the units and along with demographic questionnaire of patients, laboratory results needed for the survey (fasting blood glucose, triglycerides and HDL) with waist circumference size, blood pressure, height and weight were examined. Data after collection were analyzed using SPSS statistical software.Results:In this study of 172 patients with myocardial infarction, 56 patients (38.4%) patients were females and 112 (17.9%) were males. 1.2% of the patients were single, 84.8% were married, 0.6 were divorced and 13.5% were widowed, 116 patients (67.4%) with features of metabolic syndrome and 56 patients (32.6%) were lacking. In this study, females with myocardial infarction had more metabolic syndrome than males and in people whom relatives have a history of heart disease and also people who are overweight as well as obesity and also have features of metabolic syndrome and mean profiles of HDL, LDL, BMI, fasting blood glucose, triglyceride and waist circumference in males compared to males is higher. However, history of smoking, average number of cigarettes used per day, height and weight of males is higher than females.Other findings indicate a significant relationship between age and sex and having or not having a family history of heart failure, having or not having history of certain drugs and BMI of patient with metabolic syndrome. But a significant relationship was not found between the marital status, education, residence, income, previous history of heart disease, PCI, LDL, history of drug use, type of infarction, the extent of ejection and location with syndrome patients. In terms of survival, because none of the subjects in the study period had expired, this extent was not quantifiable.Conclusion:Considering the high prevalence of this disorder in Iran and that the high incidence of serious effects imposes on the health care system and that these disorders are somewhat flexible, effort towards lifestyle changes particularly healthy diets, physical activity, weight management and blood pressure, especially in women should be considered.

Sensitivity and specificity of different measures of adiposity to distinguish between low/high motor coordination

ObjectiveThis study aimed to determine the ability of different measures of adiposity to discriminate between low/high motor coordination and to evaluate the relationship between different measures of adiposity and motor coordination. MethodsThis study included 596 elementary school children aged 9 to 12 years (218 females – 47.1%). Weight, height, and waist circumference were objectively measured by standardized protocols. Body fat percentage was estimated by bioelectric impedance. Body mass index and waist-to-height ratio were computed. Motor coordination was assessed by the Körperkoordination Test für Kinder. Cardiorespiratory fitness was predicted by a maximal multistage 20 m shuttle-run test of the Fitnessgram Test Battery. A questionnaire was used to assess the maternal educational level. ResultsThe receiver operating characteristic performance of body fat percentage in females and waist circumference in males presented a slightly better discriminatory accuracy than body mass index, waist circumference and waist-to-height ratio in predicting low motor coordination. After adjustments, logistic regression analyses showed that body mass index (β=2.155; 95% CI: 1.164-3.992; p=0.015 for girls; β=3.255; 95% CI: 1.740-6.088; p<0.001 for males), waist circumference (β=2.489; 95% CI: 1.242-4.988; p=0.010 for girls; β=3.296; 95% CI: 1.784-6.090; p<0.001 for males), body fat percentage (β=2.395; 95% CI: 1.234-4.646; p=0.010 for girls; β=2.603; 95% CI: 1.462-4.634; p<0.001 for males) and waist-to-height ratio (β=3.840; 95% CI: 2.025-7.283; p<0.001 for males) were positively and significantly associated with motor coordination in both sexes, with the exception of waist-to-height ratio in girls (β=1.343; 95% CI: 0.713-2.528; p=0.381). ConclusionBody fat percentage and waist circumference showed a slightly better discriminatory accuracy in predicting low motor coordination for females and for males, respectively.

Demographic Variables and Histological Scoring of Non-Alcoholic Fatty Liver Disease in a Bangladeshi Population

A cross sectional study was carried out in the Department of Pathology, Dhaka Medical College, Dhaka and Department of hepatology, Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period of July 2007 to June 2009. Total 55 adult subjects of both sexes were included in this study to evaluate the histological pallern of nonalcoholic fatty liver disease (NAFLD) and its relation with demographic variables including age, sex, BMI, obesity and waist circumference. NAFLD is characterized by macrovesicular deposition of fat in liver. It is now days recognized as a major cause of liver disease and has the propensity for progression to fibrosis and cirrhosis. Study subjects with bright echogenic liver on ultrasonography with no history of alcohol consumption and without having hepatitis B and hepatitis C infections were included. All of them undergone liver biopsy and H&amp;E and Masson's Trichrome stain slides were examined to evaluate the grade and stage of lVAFLD. Scoring and semiquantitative assessment of steatosis and NAFLD severity was done according to Kleiner scale known as NAFLD Activity Score (NAS). Among the subjects 24 were male and 31 female. Mean age 41±10. 66 years (range 20 - 65 years), BMI 29.13±3. 79 kg/m2 (range 24.22 - 39.00 kg/m2), mean of male waist circumference 92.03±6.75 cm (range 88-109 cm) and mean of female waist circumference was 90.17±6.6cm (range 80-102 cm). Only BMI correlated significantly with NAS score whereas age, BMI and waist circumference of male and female subjects correlated significantly with stage of fibrosis. The study concludes that in developing countries like Bangladesh the incidental finding of NAFLD is increasing because of change in life style and food habit. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18508 Bangladesh Medical Journal 2011 Vol.40(2): 36-40

Identification of Anthropometric Indices That Best Correlate With Insulin Sensitivity and Insulin Resistance from Subjects from Central Mexico

Background: Insulin Sensitivity (IS) and Insulin Resistance (IR) mark the development of Type 2 Diabetes. Many reports have demonstrated that anthropometric indices can detect IS and IR, however ethnic variations can influence the optimal cutoff value. Therefore, the aim of this study was to determine the optimal cutoff value for Waist Circumference (WC), Body-Mass Index (BMI), Waist-To-Hip Ratio (WHR), Waist-To-Height Ratio (WHtR), and percent Body Fat (BF %) to determine IS and IR from subjects from central Mexico. Methods: WC, BMI, WHR, WHtR, BF%, fasting plasma glucose, and insulin were determined in 569 subjects (male=286 & females=283; ages: 18-84). IR and IS were determined by the Homeostatic Model Assessment online calculator and Quantitative Insulin Sensitivity Check Index, respectively. The area under the Receiver Operating Characteristic curve (AUC) and Youdens index for each anthropometric index was calculated to determine its cutoff value. Cutoff values efficiency was measured by determining the tests accuracy. Results: WC, BMI, WHtR and BF% negatively correlated IS and positively correlated to IR (p<0.0001). WHR did not correlate with IS nor IR. AUC analysis showed that WC, BMI, WHtR and BF% were acceptable test to determine IS and IR (IS: males: AUC=0.736-0.770 and females: AUC=0.648-0.666; IR: males: AUC=0.740-0.760 and females: AUC=0.681-0.709, p<0.001). Comparison of AUC demonstrated that WC, BMI, WHtR and BF% had similar efficiency to determine IS and IR. However, after determining the optimal cutoff value and using highest test accuracy, we determined the better indicators for IS was WHtR (cutoff=0.540, accuracy=76.8%) and BF% (cutoff=31.5%, accuracy=68.0%) and for IR was WC (cutoff=99.5 cm, accuracy=71.0%) and BMI (cutoff=31.6 kg/m 2 , accuracy=79.9%) for males and females, respectively. Conclusion: When comparing multiple anthropometric indices, we determined that WHtR and WC for males and BF% and BMI for females were better indicators for determining IS and IR, respectively.

Assessment of relationship between measures of obesity and arterial stiffness in young healthy adults

Background: Obesity increases the risk of cardiovascular diseases. Overweight and obese individuals have significantly stiffer arteries than normal weight individuals, which might lead on to various cardiovascular complications. Aim: This study was undertaken to assess the effect of body fat on arterial stiffness in young adults. Arterial stiffness was analyzed by stiffness index (SI) and reflection index (RI) derived from digital volume pulse (DVP) waveform. Settings and Design: A cross-sectional study was conducted among healthy adults in the age group of 17-25 years from private medical, nursing, and dental colleges in Tamil Nadu. Materials and Methods: Ninety-seven young healthy adults of both sexes in the age group of 17-25 years were included in the study. Anthropometric measures like height, total body weight, body mass index (BMI), and waist circumference (WC) were measured. SI and RI derived from the finger photoplethysmographic DVP waveform. Statistical Analysis: Associations between SI and RI, and BMI and WC were assessed with Pearson correlation coefficient. Results: There was a strong correlation between SI/RI and BMI and WC in males and females ( r > 0.9). Conclusion: Obesity is associated with arterial stiffness in the young Indian population the association between SI/RI and BMI, the age at which it appears, and the prevalence of obesity among the young adults warn us about the increase in incidence of cardiovascular diseases.

Metabolic Syndrome (MetS)

The clinical cluster of hypertension, cardiovascular disease, hyperlipemia, hyperuricemia and type 2 Diabetes had been recognized by physicians for many decades, described as syndrome X and finally metabolic syndrome (MetS). A few decades ago, investigators noted this syndrome in the alarming pandemic of obesity and type 2 diabetes. Different definitions of metabolic syndrome had been developed by the World Health Organization (WHO), the National Cholesterol Education Program me Adult Treatment Panel 111 (NCEP-ATP111) and by the International Diabetes Federation (IDF). High Triglycerides, low HDL-C, hypertension, raised fasting plasma glucose, and central obesity are essential factors. Obligatory factors such as obesity (BMI ≥ 30) and high waist circumference with ethnic specificity were required by WHO and IDF criteria respectively. Cutoff points of systolic and diastolic blood pressures, HDL-C and fasting plasma glucose of WHO criteria were required to be adjusted; and cutoff points of waist circumference for males and females of IDF were required to be standardized with European and non-European populations, South Asians and South-East Asians of WHO and IDF criteria. Later, three out of five criteria was introduced by NCEP ATP111 instead of obligatory requirements plus two out of four criteria used by WHO and IDF. To be practical for application to public health sectors, MetS has been defined by at least two criteria such as hypertriglyceridemia-waist and hypertensive-waist by validation to IDF criteria definition. Some elements of MetS are noted to be clustered more frequently in some ethnic populations. Individuals without type 2 DM, obesity or MetS are noted to have low HDL-C regardless of age in some populations, probably based on genetic susceptibility. Gender also has an impact on HDL-C level, lower in females than males in general. Then, triglycerides and total cholesterol levels increase with age.

Characteristics of white coat hypertension in Chinese Han patients with type 2 diabetes mellitus

Objectives: This study documented the prevalence and clinical features of white coat hypertension (WCH) among Chinese Han patients with type 2 diabetes mellitus (T2DM). Methods: Clinic and ambulatory blood pressure (BP) measurements were compared in 856 patients with T2DM to determine the frequency of WCH (WCH was defined as clinical blood pressure ≥140/90 mmHg and daytime blood pressure <135/85 mmHg and/or 24-h ambulatory BP (ABP) mean value of <130/80 mmHg on ambulatory BP monitoring (ABPM). Weight, waist circumference (WC), body mass index (BMI), waist to height ratio (WHtR), fasting blood glucose, glycosylated hemoglobin level and circadian BP patterns were also measured to find clinical features predictive of WCH in T2DM. Results: The prevalence of WCH was 7.36% (63/856) in the overall population, 6.13% (29/473) in male and 8.88% (34/383) in female (p < 0.05). WCH accounted for 14.03% (63/449) of diagnosed hypertension. Age, course of T2DM, male WC were independent protective factors, whereas female sex, smoking and alcohol consumption were independent risk factors for WCH in T2DM. Non-dippers and reverse dippers made up larger proportion of the WCH group (p < 0.01). Conclusion: WCH is relatively common among T2DM patients, it is a unique condition distinct from essential hypertension (EH), and WCH patients also exhibit significant differences in clinical parameters.

Sex-specific effects of weight-affecting gene variants in a life course perspective—The HUNT Study, Norway

The impact of previously identified genetic variants directly or indirectly associated with obesity, were investigated at birth, adolescence and adulthood to provide knowledge concerning timing and mechanisms of obesity susceptibility with focus on sex differences. Twenty four previously identified obesity- and eating disorder susceptibility loci were tested for association with adiposity traits at birth (ponderal index (PI)), adolescence and young adulthood (body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR)) in 1782 individuals from the HUNT study. Single-nucleotide polymorphism (SNPs) were evaluated individually and by haplotype sliding-window approach for windows50 kb (near-MC4R, FTO and near-BDNF). The analyses were performed on the total and sex stratified samples. The most substantial effect on BMI was observed for the near-MC4R variants at adolescence and adulthood (adjusted P-values in adolescence: 0.002 and 0.003 for rs17782313 and rs571312, respectively). The same variants showed inverse association with PI in males (adjusted P-values: 0.019-0.036). Furthermore, significant effects were observed at adolescence with BMI for the near-KCTD15 variant (rs11084753) (adjusted P=0.038) in the combined sample. The near-INSIG2 (rs7566605) was significantly associated to WHR in males and near-BDNF (rs925946) in the combined sample (adjusted P=0.027 and P=0.033, respectively). The OPRD1 locus was associated to BMI and WC in males both at adolescence and adulthood with highest effect in adults (adjusted P=0.058). Interaction with sex was identified for near-MC4R, OPRD1, COMT, near-BDNF and DRD2. Most obesity susceptibility variants show stronger effect at adolescence than at birth and adulthood with a clear sex-specific effect at some loci. The near-MC4R locus exhibit inverse effect on weight at birth in boys compared with findings at adolescence and adulthood. Some variants less known for obesity-susceptibility such as OPRD1 were found to be associated to weight with strongest effects in males.

The risk of Barrett's esophagus associated with abdominal obesity in males and females

Esophageal adenocarcinoma arises from Barrett's esophagus (BE). Both occur predominantly in males. The role of abdominal obesity in this sex distribution is uncertain. Our study aimed to determine whether there is an association between abdominal obesity and risk of BE and if present was it modified by sex. A structured interview and anthropometric measures were conducted within a population-based case-control study. We recruited 237 BE cases (70% male) and 247 population controls, frequency matched by age and sex. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression analysis. In the overall group and males, all measures of abdominal obesity [waist circumference (WC), waist-hip ratio (WHR), sagittal abdominal diameter (SAD) and waist-height ratio (WHtR)] were strongly associated with risk of BE (Overall: WC OR 2.2 95% CI 1.4-3.5, WHR 1.8 95% CI 1.2-2.9, SAD 2.3 95% CI 1.4-3.7, WHtR 1.9 95% CI 1.2-3.0, males WC 2.5 95% CI 1.4-4.3, WHR 2.4 95% CI 1.3-4.2, SAD 2.5 95% CI 1.4-4.3, WHtR 1.9 95% CI 1.1-3.4). These associations were minimally attenuated by adjusting for ever-symptoms of gastroesophageal reflux (GER). These findings suggest in males, non-GER factors related to abdominal obesity may be important in the development of BE. In females, there was modest association between measures of abdominal obesity and risk of BE but these were all abolished after adjusting for ever-symptoms of GER. The power to detect differences between sexes in the risk of BE associated with abdominal obesity was limited by the number of females in the study.

THE EFFECT OF OBESITY ON DETECTION RATE OF OBSTRUCTIVE SLEEP APNOEA-HYPOPNOEA SYNDROME IN HYPERTENSIVE PATIENTS

ObjectivesTo investigate the detection rate of obstructive sleep apnoea-hypopnoea syndrome (OSAHS) in hypertensive patients and the influence of obesity on it.MethodsA total of 825 in patients with hypertension were derived...

Relationships between gray matter, body mass index, and waist circumference in healthy adults.

Obesity and overweight are often defined by the body mass index (BMI), which associates with metabolic and cardiovascular disease, and possibly with dementia as well as variations in brain volume. However, body fat distribution and abdominal obesity (as measured by waist circumference) is more strongly correlated with cardiovascular and metabolic risk than is BMI. While prior studies have revealed negative associations between gray matter tissue volumes and BMI, the relationship with respect to waist circumference remains largely unexplored. We therefore investigated the effects of both BMI and waist circumference on local gray matter volumes in a group of 115 healthy subjects screened to exclude physical or mental disorders that might affect the central nervous system. Results revealed significant negative correlations for both BMI and waist circumference where regional gray matter effects were largest within the hypothalamus and further encompassed prefrontal, anterior temporal and inferior parietal cortices, and the cerebellum. However, associations were more widespread and pronounced for waist circumference than BMI. Follow-up analyses showed that these relationships differed significantly across gender. While associations were similar for both BMI and waist circumference for males, females showed more extensive correlations for waist circumference. Our observations suggest that waist circumference is a more sensitive indicator than BMI, particularly in females, for potentially determining the adverse effects of obesity and overweight on the brain and associated risks to health.

Attenuating Effect of Vigorous Physical Activity on the Risk for Inherited Obesity: A Study of 47,691 Runners

ObjectivePhysical activity has been shown to attenuate the effect of the FTO polymorphism on body weight, and the heritability of body weight in twin and in family studies. The dose-response relationship between activity and the risk for inherited obesity is not well known, particularly for higher doses of vigorous exercise. Such information is needed to best prescribe an exercise dose for obesity prevention in those at risk due to their family history.DesignWe therefore analyzed self-reported usual running distance, body mass index (BMI), waist circumference, and mother's and father's adiposity (1 = lean, 2 = normal, 3 = overweight, and 4 = very overweight) from survey data collected on 33,480 male and 14,211 female runners. Age-, education-, and alcohol-adjusted regression analyses were used to estimate the contribution of parental adiposities to the BMI and waist circumferences in runners who ran an average of <3, 3–6, 6–9, ≥9 km/day.ResultsBMI and waist circumferences of runners who ran <3 km/day were significantly related to their parents adiposity (P<10−15 and P<10−11, respectively). These relationships (i.e., kg/m2 or cm per increment in parental adiposity) diminished significantly with increasing running distance for both BMI (inheritance×exercise interaction, males: P<10−10; females: P<10−5) and waist circumference (inheritance×exercise interaction, males: P<10−9; females: P = 0.004). Compared to <3 km/day, the parental contribution to runners who averaged ≥9 km/day was diminished by 48% for male BMI, 58% for female BMI, 55% for male waist circumference, and 58% for female waist circumference. These results could not be attributed to self-selection.ConclusionsExceeding the minimum exercise dose currently recommended for general health benefits (energy equivalent to running 2–3 km/day) may substantially diminish the risk for inherited obesity. The results are consistent with other research suggesting the physical activity dose required to prevent unhealthy weight gain is greater than that recommended for other health benefits.

Evaluation of anthropometric indices of patients with left ventricle dysfunction fallowing first acute anterior myocardial infarction.

In the current study, we evaluated the effect of anthropometric indices on ejection fraction following first acute anterior myocardial infarction. In an analytic-cross sectional study, 50 patients with acute anterior myocardial infarction and abnormal anthropometric indices (Body Mass Index (BMI) ≥ 30, Waist Hip Ratio (WHR) ≥ 1 and ≥ 0.85 in males and females respectively and Waist Circumference (WC) ≥ 102 cm and ≥ 88 cm in males and females respectively) were recruited as case group and 50 patients with acute anterior myocardial infarction and normal anthropometric indices as control group. Subsequently, the relation between anthropometric indices and left ventricle dysfunction was evaluated and compared between two groups. 77 people of the studied patients were male and 23 female with the mean age of 59± 1.2 years and an age range of 32-90 years. To evaluate the left ventricle function, the mean ejection fraction of the patients was measured as 34.3± 7.2 % and 44.8± 6.3% in patients with abnormal anthropometric indices and patients with normal anthropometric indices respectively (P= 0.0001). Calculation of the correlation coefficient between ejection fraction and BMI, WHR and WC in males and females revealed a moderate reverse (r=-0.521 to r=-0.691) and statistically significant (P= 0.0001) relations which was of more strength in females. Anthropometric indices including BMI and waist circumference influence cardiac function following myocardial infarction.

Fatty Liver Is Associated with Recurrent Bacterial Infections Independent of Metabolic Syndrome

Diabetes mellitus and obesity are important components of metabolic syndrome (MetS) which are associated with infections. MetS is frequent in nonalcoholic fatty liver disease (NAFLD). The objective of this study was to examine whether patients with NAFLD are at higher risk of recurrent bacterial infections (RBIs). Two-hundred and forty-seven from 296 hospitalized NAFLD patients were assessed over a three-year period for the occurrence of RBIs and were compared with 100 age and gender-matched patients without NAFLD, who were hospitalized over the same period because of a bacterial infection. An RBI was defined as: ≥2 episodes of bacterial infections per year for a period of three consecutive years. NAFLD was diagnosed by ultrasonography. Biomarkers of inflammation, the level of oxidative stress, insulin resistance, and serum vitamin D levels were measured. NAFLD patients had significantly more RBIs than the patients without NAFLD (22% vs. 8%; P<0.001). Univariate analysis showed that age, BMI, male waist circumference, serum 25(OH)D, triglycerides, serum malondialdehyde, and paraoxonase-1 are associated with RBIs in NAFLD patients. Multivariate analysis showed that NAFLD (odds ratio (OR)=3.0, 95% confidence interval (CI)=2.6-4.2, P<0.001), serum 25(OH)D level <20ng/mL (OR=2.6; 95% CI 2.4-3.1, P=0.01), obesity (BMI >30kg/m(2) (OR=2.2, 95% CI 1.8-2.9, P=0.02) were associated with RBIs, irrespective of MetS. NAFLD is associated with increased risk of RBIs irrespective of MetS. Vitamin D insufficiency is frequent in NAFLD and is associated with increased risk of RBIs.

Serum Bcl-2 concentrations in overweight-obese subjects with nonalcoholic fatty liver disease

To shed some light on the relationship between anti-apoptotic serum Bcl-2 concentrations and metabolic status, anthropometric parameters, inflammation indices, and non-alcoholic fatty liver disease severity were investigated in 43 young individuals with fatty liver (FL) and 41 with nonalcoholic steatohepatitis (NASH). Circulating levels of Bcl-2 were detected in 84 patients with ultrasonographic findings of "bright liver" and/or hyper-transaminasemia of unknown origin and/or increase in γ-glutamyl-transpeptidase (γ-GT) strictly in the absence of other acute or chronic liver disease, whose age was not advanced, who gave consent to liver biopsy and were then divided on the basis of the histological results into two groups (43 with FL and 41 with NASH). Twenty lean subjects, apparently healthy and young, were chosen as controls. Serum Bcl-2 concentrations were significantly higher in the FL group than in the NASH group. Insulin resistance and γ-GT activity were significantly higher in NASH subjects. Apoptotic hepatocytes were significantly more numerous in NASH patients. NASH patients presented with larger spleens and augmented C-reactive protein (CRP) concentrations than healthy subjects. Steatosis grade at histology was similar in both NASH and FL populations. The number of apoptotic cells was significantly related to anti-apoptotic Bcl-2 protein values in FL patients. Bcl-2 serum levels positively correlated to body mass index (BMI) values (P ≤ 0.0001) but not to age of the population. Triglycerides/HDL ratio correlated well to waist circumference in males (P = 0.0008). γ-GT activity was associated with homeostatic metabolic assessment (HOMA) (P = 0.0003) and with serum ferritin (P = 0.02). Bcl-2 concentrations were not related to either spleen size or CRP values. NASH patients presented a weak negative correlation between lobular inflammation and Bcl-2 levels. A prediction by low values of serum Bcl-2 towards a greater presence of metabolically unhealthy overweight/obese patients (MUOs) was evidenced. HOMA, BMI and uric acid, in that sequence, best predicted serum Bcl-2 concentrations. MUOs could be detected by Bcl-2 levels. By favoring the life span of hepatocytes, and enhancing triglyceride formation, the anti-apoptotic process inhibits free fatty acids toxicity in FL.

Gender differences in body composition, inflammatory markers and risk of metabolic abnormalities in Arabs

Abstract Background: Metabolic syndrome may be a result of both increased and/or inappropriate fat accumulation. As a consequence of the obesity epidemic, which has particularly manifested amongst the populations of the Arabian Gulf, associated with increases in type 2 diabetes mellitus and cardiovascular diseases, metabolic syndrome is becoming an increasing problem. Recent studies from the Gulf region have highlighted that women are more at risk than men. The effect of gender on fat accumulation and distribution, as well as its secretory function, are yet to be studied. Purpose: The aim of our study was to investigate gender differences in body composition, aerobic fitness, adipokines and inflammatory markers in a cohort of healthy Qatari adults. Methods: This was a prospective case-control study of healthy Qatari adults (18-50 years of age), comprised of 29 women matched with 29 men for age and body mass index. Detailed investigations included body composition by anthropometric measurements, DXA and CT scans to assess total and regional fat distribution. Subjects were also evaluated for their aerobic fitness and indices of muscular strength. Hematological investigations included fasting glucose, insulin, HOMA-IR, lipid profile analysis, adipokines (s-adiponectin, leptin) and inflammatory markers (IL-6, MCP-1, CRP, S.RANTES). Results: Waist circumference in males (95.4±17.4 cm) and females (90.1±11.3 cm) was comparable (p=0.192). CT scan results revealed that women accumulate comparatively more fat in the total abdominal (p=0.036), and abdominal sub cutaneous (p=0.066) and total thigh (p<0.001) regions. No differences were detected in HOMA-IR, and despite very high adiposity, the lipid profile was favorable in females (TG=0.8±0.4 vs. 1.2±0.5 mmol/L and LDL=2.8±0.7 vs. 3.2±0.9 mmol/L). Poor aerobic fitness (<50th percentile) was observed in both groups 96% in women compared to 70% in men (p<0.001). S-adiponectin and leptin levels were significantly elevated in females, whereas CRP, IL-6, MCP-1 or S.RANTES were no different. Conclusion: Elevated leptin concentration in women was attributed to a high percentage of central obesity in the test subjects. The presence of higher levels of s.-adiponectin led to a favorable lipid profile in women. In contrast, deleterious gender differences in aerobic fitness within this population is of critical relevance and must be further investigated.

Concordancia de tres definiciones de síndrome metabólico en pacientes hipertensos

Determining agreement between three definitions of metabolic syndrome (MS) in hypertensive Colombian patients. A descriptive study of 323 hypertensive patients from Cartagena, Colombia, was designed. A medical history was compiled; waist circumference, serum lipids and fasting serum glucose were recorded. MS prevalence was compared by using by the definitions provided by the Adult Treatment Panel III (APT III), the American Heart Association (AHA), the International Diabetes Federation (IDF) and a modified IDF (> or = 88 cm waist circumference in males). Cohen's kappa test was used for evaluating agreement between means. 77.5% of the patients were female. MS overall prevalence was 59.9% according to ATP III, 83.6% by AHA, 81.2% by IDF and 92.9% by IDFm. Agreement was fairly clear when comparing the definitions, except when comparing the IDFm one with ATP III and AHA. The greatest agreement was provided when comparing IDF to AHA (kappa= 0.638). MS prevalence was higher in hypertensive Colombian patients than in other countries, probably because the greater prevalence of its components. Clear agreement was shown when comparing most definitions, apart from poor correlation between criteria compared using IDFm (except with non-modified IDF).

Investigation of the body composition and the risk of hypertension in Fuzhou area

Objective To analyze boby composition and establish the regression equation of body fat(% BF) in a sample of six hundzed and two adults in Fuzhou area,and to assess the prediction of % BF for risk of hypertension in the population.Methods Six-handred and two subjects in Fuzhou,310 men and 292 women,were investigated.Constituent ratio of all age groups were equal to the Fuzhou residents (5 years and above).Blood pressure,height,weight,waist circumference,body mass index (BMI) of selected groups were measured.Total body fat mass and total body lean mass were measured by dual-energy X-ray absorptiometry (DEXA).The characteristics of waist circumference,BMI and body composition were analyzed.The optimal waist circumference and % BF cut-points were searched using X2 test to accord with the criterion of BMI ≥25 kg/m2.The prediction formula for % BF was assessed by multiple linear regression.The prediction of % BF for risk of hypertension for the population was assessed by logistic regression.Results The older subjects appeared to have higher % BF and fat mass/lean mass ratio,and % BF of adult females was significantly higher than the males'.The best cut-points were 25% for % BF and 85 cm for waist circumference in males,and 35% and 80 cm in females.Logistic regression analysis showed that the expected odds ratios of hypertension were 1.49 in males and 1.75 in females by every adding level of age,and 1.57 in males and 1.65 in females by every adding level of % BF.The waist circumference and BMI did not enter the regression equation.Conclusion The optimal % BF cut-points are 25% for male and 35% for female.% BF is better than BMI and waist circumference in predicting risk of hypertension. Key words: Body mass index; Waist circumference; Body composition; Hypertension