Waist Hip Research Articles

Individualized generation of young women's crotch curve based on body images

To improve the clothing fit at the crotch position, this study proposed a method to generate the crotch curve of the human body based on image measurements. 152 female college students aged 18–25 were measured through 3D point-cloud data, and the parameters related with the crotch shape, including heights and thicknesses, were obtained according to 11 key points on the crotch curve for correlation and regression analysis. The fitting rules of the crotch curve were built with five parameters, including waist thickness, waist-hip height, abdominal thickness, hip thickness and waist-abdomen height. To realize the automatically simulation based on body images, the navel point, abdomen convex point and buttock point were analyzed to exact the five parameters based on the human contour, and then 11 key points on the crotch curve could be determined. Through comparison, the result shows that the fitted crotch curve is basically consistent with the actual crotch curve, and the errors of four parameters are mainly between −5 and 5 mm. The generation method of the individual crotch curve based on body images were feasible, and can provide a new thought to realize the 3D modeling based on body images.

The relation of dietary components with severity of obstructive sleep apnea in Cypriot patients: A randomized, stratified epidemiological study.

BackgroundObstructive Sleep Apnea (OSA) is considered a public health problem and its prevalence is increasing at an epidemic rate. The aim of this study was to examine whether individual nutrients (macronutrients, antioxidant vitamins) rather than energy restriction may potentially affect OSA severity in a representative population of Cyprus.MethodsA total sample of 303 adults (>18 years old) with Cypriot citizenship and permanently residing in Cyprus were randomly selected. Selected patients have completed the food frequency questionnaire, and a physical activity questionnaire and underwent a sleep study to assess OSA severity.ResultsOverall, 303 patients were included in this study, 169 (55.8%) had mild OSA (apnea-hypopnea index—AHI <15) and the remaining 83 (27.4%) had moderate to severe OSA (AHI>15). The mean age of all patients was 55.7 years old. Patients with moderate to severe OSA had significant higher BMI levels, higher consumption of calories, higher hip circumference, waist circumference, waist-hip ratio and neck circumference and higher consumption of folic acid compared with the patients with mild OSA (p<0.05).ConclusionsThe findings suggest that increased energy intake regardless diet macronutrient composition is positively associated with OSA severity whereas higher folic acid intake seems to have a protective role.

Correlation of waist circumference, hip circumference and waist-hip ratio with VCTE in lean and non-lean NAFLD

Background and Aim: Waist circumference (WC) is a measure of abdominal adiposity, an important predictor of Non alcoholic fatty liver disease (NAFLD). Waist-to-hip ratio (WHR) also has a strong correlation with development of NAFLD. Vibration-controlled transient elastography (VCTE) is a widely used noninvasive technique for assessment of liver fibrosis. We tried to compare the WC, Hip circumference (HC) and WHR in lean and non lean NAFLD and to assess the correlation between WHR and VCTE. Methods: Cross-sectional observational study including 120 lean (BMI<23kg/m2 ) and 120 non-lean (BMI>23kg/m2 ) NAFLD patients. Liver stiffness was determined using VCTE (Fibroscan 502, Echosens, Paris, France) in kilopascals (kPa). Comparison of categorical variables was done using Chi-square (Î2) test. Pearson’s correlation coefficient was used to test the strength of correlation. Univariate linear regression was used to predict the relation between WHR and VCTE. Results: 105(87.5%) of non-lean NAFLD and 59(49.17%) of lean NAFLD patients were found to have high WC (p<0.001), but the proportion of patients having high WHR was comparable in both the groups (p=0.551). Compared to the lean NAFLD population, WC and HC were significantly higher in the non-lean group (p<0.001 for both), but mean WHR were comparable between lean (0.93+0.14) and non-lean (0.94+0.14) groups (p=0.639). Mean VCTE was also comparable in lean NAFLD (8.18+2.23) and non-lean NAFLD (7.74+2.54), (p=0.162). Both HC and WC had poor correlation with VCTE. Mean WHR had a moderately strong correlation with VCTE in non-lean NAFLD (r=0.326) and a weak correlation in lean NAFLD (r=0.169). On univariate linear regression, the relationship between WHR and VCTE was significant in non-lean NAFLD (Î2=5.226, p=0.002), but not in lean NAFLD (Î2=2.665, p=0.064). Conclusions: High WHR has significant correlation with liver fibrosis in non-lean NAFLD, but not in lean NAFLD. Individually, WC and HC do not correlate significantly with VCTE.

Anthropometrics and Myocardial Infarction Risk: A Misleading Evidence Was Accepted by Cardiovascular Sciences When Errors of Bias Were Overlooked Worldwide. When Should We End Discussion about the Optimal Metric?

Despite the impact of the COVID‑19 pandemic, myocardial infarction remains the leading cause of cardiovascular deaths in Europe. Body mass index (BMI)-defined obesity is a major risk factor for myocardial infarction. However, in the association of anthropometrics and myocardial infarction, the lack of balance between the simple body measurements when comparing healthy and unhealthy cases has demonstrated that affects the outcome. Thus, regardless of association strength of anthropometrics, other criteria to judge the biological causality must be investigated. We aim to assess different studies worldwide to understand the key concepts to demonstrate association biases for anthropometrics when predicting myocardial infarction risk. In this approach, natural mathematical inequalities between simple measurements in healthy subjects were investigated. Weight, height, height/2, waist circumference and hip circumference mathematically represent absolute values that do not express mathematically equality for the true risk. That way, the mathematical concept of fraction or ratio in anthropometrics such as BMI, waist-to-hip ratio (WHR) or waist-to-height ratio (WHtR) plays an important role. Thus, some anthropometrics may be seen as confounding variables when measuring high-risk body composition. Weight is a confounding factor without indicating a high-risk body composition, meaning that BMI is not fully predictive. WHR is a confounding variable concerning waist and WHtR due to imbalances between the mean hip–waist and hip–height, respectively, which indicates a protective overestimation for hip concerning waist and height. Waist measure may be a confounding variable concerning WHtR due to an imbalance in the mean waist–height. This occurs if, and only if, WHtR risk cut-off is &gt;0.5 and if height is ignored as volume factor, therefore creating an overestimation of risk for waist circumference in the tallest people and underestimation in the shortest. Mathematically/anthropometrically, only WHtR-associated risk above BMI, waist and WHR holds true while considering it as a relative risk volume linked to a causal pathway of higher cardiometabolic risk. In conclusion, WHtR is the only metric that is directly associated to a risk volume and having more biological plausibility. It should be used to assess the anthropometrically-measured myocardial infarction risk, once the imbalances between measurements and association biases are recognised.

Association of anthropometric measures of obesity and physical activity with cardio-vascular diseases among older adults: Evidence from a cross-sectional survey, 2017-18.

BackgroundWith the increase in elderly population, the risk of cardiovascular diseases (CVD) among Indian older adults is also increasing. The present paper tries to assess how different anthropometric measures of obesity and physical activity affects cardiovascular disease risk among older adults in India.MethodsThe data from Longitudinal Ageing Study in India (LASI) has been used. The total sample size for the present study is 31,464 older adults aged 60 years and above. Chi-square test and binary logistic regression has been used to measure the association of obesity measures and CVD prevalence.ResultsAbout 35.2% (n = 11,058) of the older adults suffered from CVD. Moreover, 22.2% (n = 6,217) of the older adults were obese/overweight, 23.7% (n = 6,651) had high risk waist circumference and 77.0% (n = 21,593) had high risk waist-Hip ratio. The likelihood of CVD was 60%, 50%, and 34% significantly higher among older adults who were obese/overweight [Adjusted odds ratio (AOR): 1.60; CI: 1.48–1.72], had high risk waist circumference [AOR: 1.50; CI: 1.39–1.62] and high risk waist-Hip ratio [AOR: 1.34; CI: 1.25–1.44], respectively compared to older adults with normal BMI and those who do not have a high risk waist circumference and high risk waist hip ratio. Moreover, older adults who never did physical activity had 22 per cent higher risk of CVD than those who did frequent [AOR: 1.22; CI: 1.13–1.32] physical activity.ConclusionThe burden of overweight and obesity along with physical inactivity increases the risk of CVD in older adults. These findings highlight the urgent need for framing direct and indirect strategies to control obesity in order to reduce the burden of CVD among older adults in India.

Anthropometric measures and the risk of developing atrial fibrillation: a Swedish Cohort Study

AimsObesity is a risk factor for several cardiovascular diseases (CVDs), including atrial fibrillation (AF). However, it is less clear whether overall fat or abdominal fat distribution are most important for risk of developing AF. This study investigates how different anthropometric measures correlate to the risk of developing clinical AF in the Malmö Diet and Cancer cohort (MDC-cohort).MethodsThe MDC-cohort (n = 25,961) was examined in 1991–1996. The endpoint was clinical AF diagnosed in a hospital setting, and retrieved via linkage with national registers. Hazard Ratios (HR) for incident AF was calculated in relation to quartiles of body mass index (BMI), waist circumference, waist hip ratio, waist height ratio, body fat percentage, weight and height, using Cox regression with adjustment for age, biological (e.g. blood pressure, diabetes, blood lipid levels), and socioeconomic risk factors.ResultsAfter adjustment for multiple risk factors, the risk of AF was significantly increased in the 4th versus 1st quartile of weight (HR for men/women = 2.02/1.93), BMI (HR = 1.62/1.52), waist circumference (HR = 1.67/1.63), waist to hip ratio (HR = 1.30/1.24), waist to height ratio (1.37/1.39) and body fat percentage (HR = 1.21/1.45) in men/women. Measures of overall weight (BMI, weight) were slightly more predictive than measures of abdominal obesity (waist hip ratio and waist height ratio) both in men and women.ConclusionAll measures of obesity were associated with increased risk of developing AF. Both overall obesity and abdominal obesity were related to incidence of AF in this population-based study, although the relationship for overall obesity was stronger.

Role of C-reactive protein and gamma-glutamyl transferase in the diagnosis of metabolic syndrome

Previous studies have reported that metabolic syndrome (MetS) is associated with an increased risk of major cardiovascular events and levels of C-Reactive protein (CRP) can be considered as markers of MetS and its constituent components. Oxidative stress plays a major role in the development of MetS, and levels of gamma-glutamyl transferase (GGT) change with response to oxidative stress are also associated with MetS, which may be modulated by CRP. This study was conducted to identify the role of GGT and CRP as biomarkers in the diagnosis of MetS, a high-risk factor for cardiovascular diseases. One hundred and fifty patients meeting the diagnostic criteria of MetS and an equal number of controls were included in the study. The cases were selected from pathology and molecular biology laboratories, Karachi, while the controls came from the general population. Anthropometric indices of adiposity and blood pressure were recorded for both cases and controls. Blood samples were taken from all subjects to determine the levels of CRP and GGT. All those cases and control height, weight, hip waist circumference were noted and the comparison of CRP and GGT by applying students' t-test as markers for detection of metabolic syndrome. p-value 0.001 was considered as significant. This study suggests that in patients with metabolic syndrome were found to have raised the basal metabolic rate, C-reactive protein and GGT were synergistically associated with MetS independently of another confounding factor in the general population. Keywords: C-reactive protein (CRP), gama glutamyl transferase (GGT), metabolic syndrome, (Met-S), inflammation, body mass index.

Identifying modifiable risk factors of lung cancer: Indications from Mendelian randomization.

BackgroundLung cancer is the major cause of mortality in tumor patients. While its incidence rate has recently declined, it is still far from satisfactory and its potential modifiable risk factors should be explored.MethodsWe performed a two-sample Mendelian randomization (MR) study to investigate the causal relationship between potentially modifiable risk factors (namely smoking behavior, alcohol intake, anthropometric traits, blood pressure, lipidemic traits, glycemic traits, and fasting insulin) and lung cancer. Besides, a bi-directional MR analysis was carried out to disentangle the complex relationship between different risk factors. Inverse-variance weighted (IVW) was utilized to combine the estimation for each SNP. Cochrane’s Q value was used to evaluate heterogeneity and two methods, including MR-Egger intercept and MR-PRESSO, were adopted to detect horizontal pleiotropy.ResultsThree kinds of smoking behavior were all causally associated with lung cancer. Overall, smokers were more likely to suffer from lung cancer compared with non-smokers (OR = 2.58 [1.95, 3.40], p-value = 2.07 x 10−11), and quitting smoking could reduce the risk (OR = 4.29[2.60, 7.07], p-value = 1.23 x 10−8). Furthermore, we found a dose-response relationship between the number of cigarettes and lung cancer (OR = 6.10 [5.35, 6.96], p-value = 4.43x10-161). Lower HDL cholesterol could marginally increase the risk of lung cancer, but become insignificant after Bonferroni correction (OR = 0.82 [0.68, 1.00], p-value = 0.045). In addition, we noted no direct causal relationship between other risk factors and lung cancer. Neither heterogeneity nor pleiotropy was observed in this study. However, when treating the smoking behavior as the outcome, we found the increased BMI could elevate the number of cigarettes per day (beta = 0.139[0.104, 0.175], p-value = 1.99x10-14) and a similar effect was observed for the waist circumference and hip circumference. Additionally, the elevation of SBP could also marginally increase the number of cigarettes per day (beta = 0.001 [0.0002, 0.002], p-value = 0.018).ConclusionSmoking behavior might be the most direct and effective modifiable way to reduce the risk of lung cancer. Meanwhile, smoking behavior can be affected by other risk factors, especially obesity.

Abdominal and gluteofemoral fat depots show opposing associations with postprandial lipemia

High postprandial lipemia is associated with increased risk of cardiovascular disease, independently of fasting lipid concentrations. Abdominal and gluteofemoral fat depots handle lipoproteins differently, which could affect postprandial lipemia and contribute to the relation between abdominal fat distribution and cardiovascular disease risk. We aimed to study the influences of higher abdominal compared with gluteofemoral fat on postprandial lipemia after a high-fat meal in individuals with obesity. A total of 755 adults with obesity from a randomized controlled trial in 7 European countries consumed a liquid high-fat meal. Concentrations of triglycerides (TG), glycerol, free fatty acids, and the cholesterol component of remnant-like particles (RLP), LDL, and HDL were measured postprandially for 3 h. Associations of waist circumference (WC), hip circumference (HC), and waist-hip ratio (WHR) with changes in postprandial lipid concentrations, adjusted for fasting concentrations and BMI, were examined using linear regression models. To assess whether the association of WHR with postprandial lipemia could be causal, we performed instrumental variable analyses using a genetic score of 442 variants known to be associated with WHR adjusted for BMI in 2-stage least-squares regression models. WHR was associated with higher TG and RLP cholesterol concentrations, independent of fasting lipid concentrations and BMI. Instrumental variable analyses suggested that the associations of WHR with postprandial TG (β=0.038 μmol/L*min, SE=0.019 μmol/L*min, P=0.044) and RLP cholesterol concentrations (β=0.059 mmol/L, SE=0.025mmol/L, P=0.020) may be causal. WC and HC showed opposite effects: higher WC was associated with higher TG and RLP cholesterol concentrations whereas higher HC was associated with lower concentrations. Our results suggest that higher fat deposition abdominally versus gluteofemorally may be causally associated with elevated postprandial lipemia after a high-fat meal, independent of fasting lipid concentrations and BMI. Furthermore, higher abdominal and gluteofemoral fat depots show opposing effects on postprandial lipemia.This trial was registered at www.isrctn.com as ISRCTN25867281.

Waist and hip circumference are independently associated with the risk of liver disease in population-based studies.

While several anthropometric measures predict liver disease, the waist-hip ratio (WHR) has shown superiority in previous studies. We analysed independent and joint associations of waist circumference (WC) and hip circumference (HC) with liver disease and liver-related risk factors. Cross-sectional study (n=6619) and longitudinal cohort (n=40923) comprised individuals from Health 2000 and FINRISK 1992-2012 studies. Prevalent and viral liver diseases were excluded. Longitudinal cohort was linked with national healthcare registers for severe incident liver disease. Linear regression and Cox proportional hazards models were used to analyse anthropometric, lifestyle, metabolic and bioimpedance-related parameters; liver enzymes; and 59 liver-related genetic risk variants. WC and HC showed independent and opposite associations with both liver enzymes and incident liver disease among men (HR for liver disease: WC, 1.07, 95% CI 1.03-1.11; HC, 0.96, 95% CI 0.92-0.99; P-range .04 to <.001) and women (HR for liver diseases: WC, 1.06, 95% CI 1.02-1.10; HC, 0.93, 95% CI 0.89-0.98; P-range .005 to .004). HC modified associations between WC and liver enzymes, and between WC and incident liver disease, particularly among men. Liver enzymes and risk of liver disease increased with increasing WC, more so among individuals with high WHR compared to with low WHR. WC and HC jointly reflected both body fat distribution and muscle mass, which was largely mirrored by WHR. WC and HC exhibit independent and joint associations with liver disease, which are largely reflected by WHR. Both body fat distribution and muscle mass contribute to these anthropometric measures.

Деякі аспекти діагностики абдомінального ожиріння в міського населення України

Актуальність. Оптимізація профілактичних підходів щодо розвитку коморбідної патології в осіб із надлишком ваги різного ступеня — актуальна проблема медичної науки. Ефективність таких підходів залежить від усього спектра патогенетичних факторів щодо метаболічних ускладнень ожиріння — основи розвитку коморбідної патології та виділення найбільш інформативних маркерів їх розвитку. Такими факторами є зміни адипокіноцитокінової системи (маркером яких є вміст у сироватці крові фракталкіну, кластерину, васпіну, оментину) та пов’язані з ними порушення метаболізму вільних жирних кислот. Проте виявлення вищезазначених маркерів у більшості лікувальних закладів не проводиться. Дослідження інформативності обох цих критеріїв щодо оцінки зміни адипокіноцитокінової системи та пов’язаних із ними порушень метаболізму вільних жирних кислот у представників української популяції не здійснювалися. Мета: оцінити інформативність таких критеріїв абдомінального ожиріння, як окружність талії та співвідношення окружність талії/окружність стегон, щодо ризику розвитку локального запалення жирової тканини, системного низькоінтенсивного запалення в організмі, змін секреторної функції жирової тканини та метаболічних особливостей у міських мешканців — представників української популяції. Матеріали та методи. Обстежено 250 осіб віком 65,48 ± 11,86 року, у яких імуноферментним методом визначено вміст фракталкіну, кластерину, васпіну, оментину та лептину в циркуляції; методом Данкомба — вільних жирних кислот. Проаналізовано характер взаємозв’язків вищезазначених параметрів з окружністю талії та стегон, співвідношенням окружність талії/окружність стегон. Виявлено характер вірогідних відмінностей щодо цих параметрів за наявності та відсутності абдомінального ожиріння згідно з критерієм «окружність талії/окружність стегон». Результати. Визначено, що параметр «окружність талії» є інформативним критерієм ризику розвитку запальних процесів в організмі, змін метаболізму васпіну, оментину, лептину та вільних жирних кіслот; параметр «окружність талії/окружність стегон» — змін метаболізму лептину та вільних жирних кислот. Висновки. Розвиток абдомінального ожиріння супроводжується збільшеним ризиком локального запалення жирової тканини, системного низькоінтенсивного запалення в організмі, змінами її секреторної функції щодо адипокінів васпіну та оментину, зростанням рівнів вільних жирних кислот та лептину в циркуляції. Визначено вірогідний взаємозв’язок між ступенем накопичення жирової тканини як у вісцеральному, так і в глютеофеморальному жировому депо із змінами метаболізму адипокінів васпіну та оментину.

RELATION BETWEEN SERUM FERRITIN AND VISCERAL FAT MASS IN AIN SHAMS MEDICAL STUDENTS

Background: Adipocytes are not just storage organs for fat, they play a regulatory role in body homeostasis including iron metabolism. Concerns about the effect of visceral fat mass on serum ferritin has been raised as increase visceral fat mass accumulation may lead to sequestration of Fe within the reticuloendothelial system leading to decrease dietary Fe absorption from the intestineAim of the work: This study aims to detect relation between percentage of visceral fat mass and serum ferritin level in Sample of Ain Shams medical students.Patients and Methods: this was a case–control study conducted on 150 medical students over 3 months they were divided into two subgroups: normal serum ferritin group and low serum ferritin group. All students were subjected to the detailed history and 24 hour dietary recall, anthropometric measurements, complete blood picture, measurement of serum ferritin=Results: There were significantly negative association between visceral fat mass and serum ferritin also the serum ferritin showed significant positive correlations with BMI and waist hip ratio.Conclusion: Higher visceral fat mass levels should be taken into account when assessing body Fe status and should probably be treated before providing dietary recommendations to correct low serum ferritin level.

Vitamín D a nealkoholová steatóza pečene u detí

Background: Insulin resistance (IR) plays a key role in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Hypovitaminosis D is associated with several diseases, including hepatic steatosis and obesity. Vitamin D (VD) affects insulin secretion and improves tissue sensitivity to insulin, suggesting that hypovitaminosis D is also associated with IR. The leptin-to-adiponectin ratio (LAR) was investigated as a new marker of IR. Aim: The aim of our study was to determine the association between the VD status, NAFLD and IR in paediatric overweight or obese patients. Methods: The study ran from January 2018 to August 2020 and included 100 subjects. We measured their anthropometric parameters, determined their basic laboratory parameters and the level of leptin and adiponectin, calculated BMI, WHR, WHtR, LAR and HOMA-IR. We measured the degree of hepatic steatosis by obtaining the hepatorenal index (HRI) using ultrasonography, and used real-time elastography to determine the elasticity of the liver parenchyma (LFI). Subsequently, we compared the groups of patients with and without hepatic steatosis and looked for correlations in relation to the level of VD and IR. Results: 4.4% of patients had a severe VD deficiency, 55% of the children had hypovitaminosis D, 28.6% had VD insufficiency and 12% of patients had sufficient VD levels. Patients with significant hepatic steatosis (HRI 1.5 and more) had the lowest level of VD (16.61 ±5.62 μg/l, P = 0.015). The level of VD in patients with hepatic steatosis was inversely correlated with waist circumference, hip circumference, height, weight, triacylglycerols, GMT, C-peptide, insulin, HOMA-IR, HRI and LFI. Leptin levels were highest in patients with hepatic pre-steatosis. LAR was highest in the group with hepatic steatosis, but we did not observe significant correlations in relation to other parameters. Conclusion: VD levels are inversely associated with the degree of hepatic steatosis in overweight or obese paediatric patients. HOMA-IR inversely correlates with VD levels and positively with LFI. The LAR value was highest in the group of patients with steatosis, although we did not find out any significant correlations in relation to VD status and HRI. Key words: vitamin D – non-alcoholic fatty liver disease – insulin resistance – leptin – adiponectin – obesity – childhood

Correlation of Serum Ferritin and Adenosine Deaminase with Body Mass Index in Children: A cross-sectional study

Objectives: The objectives of the study were to correlate the levels of two markers of inflammation, serum Ferritin and adenosine deaminase (ADA), with anthropometric measurements in children. Materials and Methods: This cross-sectional study was performed in a total of 60 apparently healthy children (30 in each group), aged 6–14 years whose anthropometric measurements were taken and grouped as normal and obese as per body mass index (BMI), and their serum levels of ADA, Ferritin and Lipids were analyzed. Results: Serum Ferritin, ADA, total cholesterol, and low-density lipoprotein cholesterol levels were significantly higher in the obese compared to normal children. The systolic blood pressure (SBP) was significantly higher in obese children, though the diastolic BP was similar across the groups. There was a strong positive correlation of the SBP, serum Ferritin and ADA with BMI. Ferritin showed a statistically significant positive correlation with waist circumference, hip circumference, waist-hip ratio (WHR), and triceps skinfold thickness. ADA, too, positively correlated with all anthropometric values, though it was statistically significant only with the SBP and WHR. Conclusion: Serum Ferritin and ADA, which are markers of inflammation, were elevated in obese children compared to normal children. These biochemical markers may predict non-communicable diseases than cumbersome markers like anthropometric indices in the future.

P–374 Investigating causality of risk factors for miscarriage – a Mendelian randomization analysis

Abstract Study question Do modifiable risk factors such as smoking, alcohol or coffee consumption, and adiposity causally increase the risk of sporadic or recurrent miscarriage? Summary answer We found evidence for a causal relationship between smoking initiation and sporadic miscarriage, but not for any other risk factor tested. What is known already Miscarriage is estimated to end between 10–25% of clinically confirmed pregnancies, and many observational studies have suggested numerous lifestyle factors, such as coffee and alcohol consumption, smoking and increased adiposity, may increase miscarriage risk. However, results are not always consistent across studies, and definitive causal relationships between various risk factors and miscarriage have not yet been demonstrated. Mendelian randomization utilizes genetic variants significantly associated with heritable risk factors (i.e. at P-values &amp;lt;5x10–8 in large genome-wide association studies) as instrumental variables to investigate causality of risk factors in population health outcomes. Study design, size, duration We conducted two-sample Mendelian randomization analyses to investigate causality of smoking (initiation and quantity), alcohol and coffee consumption (quantity), and adiposity (body mass index and waist-hip ratio) in sporadic and recurrent miscarriage. Data included in this study were taken from previously published summary genetic association statistics (betas, standard errors and P-values) from large-scale genome-wide association studies (GWAS) for each risk factor, and from our recently published GWAS of sporadic and recurrent miscarriage. Participants/materials, setting, methods Instrumental variables were constructed using 5–306 genetic variants significantly associated with the listed risk factors in published GWAS (minimum N = 178,000 individuals). Two instrumental variables were constructed per risk factor using data from different GWAS. Associations of the instrumental variables with miscarriage were investigated using summary association data from women of European ancestry included in our miscarriage GWAS, including 49,996 sporadic miscarriage cases and 174,109 female controls, and 750 recurrent miscarriage cases and 150,215 female controls. Main results and the role of chance We found a significant association between sporadic miscarriage and the instrumental variables for two smoking measures: smoking initiation (inverse variance weighted Odds Ratio = 1.17, 95% confidence intervals = 1.10–1.24, P = 2.7 x 10–07) and lifetime smoking (inverse variance weighted Odds Ratio = 1.22, 95% confidence intervals 1.11–1.35, P = 4.2x10–5). No other risk factors (smoking quantity, coffee or alcohol consumption, or BMI or waist-hip ratio) were associated with either sporadic or recurrent miscarriage. A priori power calculations considering the amount of phenotypic variance in each risk factor explained by the associated SNPs suggested our analysis to have at least 75% power to detect an association with Odds Ratio of 1.2 with sporadic miscarriage for analyses of body mass index, waist hip ratio and smoking initiation, quantity and the lifetime smoking measure, but that the alcohol and coffee consumption analyses were underpowered (4.9% and 48%, respectively). All analyses were underpowered for recurrent miscarriage given the small case sample size (N = 750). Limitations, reasons for caution While data utilised here come from large-scale GWAS including 1000s of individuals, genetic variants significantly associated with each risk factor currently explain small percentages (0.02–6%) of the variance in each trait. Larger GWAS for specific risk factors, and for sporadic and recurrent miscarriage, are required to clarify some published associations. Wider implications of the findings: We find no evidence of a causal link between adiposity and miscarriage, indicating that observational findings of increased miscarriage risk with increasing body mass index require further explanation. Significant associations between measures of ever-smoking and sporadic miscarriage highlights that no amount of smoking is safe in regards to miscarriage risk. Trial registration number Not applicable

RELATIONSHIP OF BODY MASS INDEX AND WAIST-HIP RATIO AMONG DENTAL INTERNS, RESIDENTS AND DENTAL PRACTITIONERS

Background: Obesity is common global problem associated with co-morbid condition such as diabetes and hypertension. There is change in fat distribution pattern in both male and female during the process of aging. Body mass index along with waist circumference, waist-hip ratio and waist to height ratio are major anthropometric measures used to define the adiposity. This study aimed to assess the prevalence of overweight and obesity in individuals of different age-group’s as dental interns, residents, and dental practitioners. Methods: This cross-sectional study was conducted among 90 male and female subjects. Census method of sampling was used as all the interns, residents and dental practitioners were involved. Unstrectable measuring tape was used to measure waist circumference, digital weighing machine was used to measure weight and Standiometer was used to measure height as per world health organization guidelines. Body mass index was calculated from the weight of participants in kilo­grams divided by square of height in meters (kg/m2). Waist-hip ratio and waist to height ratio were calculated from measured data. Data was analyzed by Stastical Package for Social Sciences (SPSS) version 16. Results: Body mass index was found to be higher in male i.e 62.5% for overweight category com­pared to female where it was 24.2% and obesity was also higher among males while comparing with females. Waist circumference has significant correlation in male and female P&lt;0.05. Waist hip ratio and different age groups also has positive correlation. Conclusions: Prevalence of overweight and obesity was seen among different age-groups and co­herently the associated disease risk was explored.

Résultats d’une intervention pluridisciplinaire en thérapie comportementale, psycho-nutrition et activité physique sur les troubles alimentaires d’adultes en surpoids entre 2016 et 2018

ObjectivesThere is a growing need to build healthcare program addressed to overweighed and obese people suffering from eating disorders. The program named “Surpoids Objectif Forme Training” (SOFT) is dedicated to eating disorders care in overweighed people. In this study we wanted to assess severity of eating disorder before, and after the intervention with measuring Three Factors Eating Questionnaire (TFEQ) score in all patients who attended the program between years 2016 and 2018. Materials and methodsSOFT is a multidisciplinary intervention organised for outpatients in Hospital La Casamance located in Aubagne, France. For each SOFT intervention lasting 10 weeks, patients were attending 40 sessions: 10 sessions in cognitive therapy in order to understand compulsive eating and to increase emotions skills (to recognize and to face emotions) and alternative behaviours; 10 sessions in psycho-nutrition with working on cognitive flexibility, connection to present and to senses (mindful eating) and recognizing sensations of hunger and satiating; 10 sessions of physiotherapy to get aware of body needs with hypopressive gymnastics and proprioceptive training; 10 sessions in adapted physical activity to encourage daily moderate physical activity and to introduce changes in patients way of living. This study was a prospective cohort study, in which we included all overweighed adults patients suffering from compulsive eating disorder including binge eating disorder and night eating syndrome. We wanted to assess TFEQ score before and after the program. We also measured Body Mass Index (BMI), bioelectrical impedance (muscle and fat mass), waist and hip circumferences, waist-hip ratio, endurance with 6minutes walking test and muscle strength. ResultsTwo hundred and one patients were included and 168 followed the entire program. The average BMI in our group was 35kg/m2. Less than 25% of patients were suffering of binge eating disorder but most of patients had compulsive eating (65%). More than 50% of them had a TFEQ score higher than 25 before entering the program (average TFEQ was 25.2). After the program average TFEQ score had decreased from 25.2 to 20.0 (P<10−4), with only 17.9% of patients with a TFEQ score above 25. These results showed improvement of severity of eating disorders with our multidisciplinary intervention. The cognitive restraint factor (F1) was not significantly decreased after intervention (P=0.884), but disinhibition factor (F2) and hunger factor (F3) were significantly decreased (P<10−4 for both) showing less compulsive behaviours and better hunger perception. BMI was also decreased after the intervention from 35.8 to 35.5 (P=0.003). Waist hip ratio decreased from 0.86 to 0.85 (P=0.002) but muscle and fat mass were not significantly changed. Physical activity parameters were also improved, with 586 meters distance in 6minutes walking test instead of 499 meters (P<10−4) and 30 repetitions instead of 25 (P<10−4) in one minute sit-to-stand test. ConclusionsMost of patients were female, usually more frequent in eating disorders patients. More than 65% of patients had compulsive disorders without BED, which shows probably numerous atypical forms. Severity of eating troubles was decreased after intervention in disinhibition and perception of hunger, but cognitive restriction was increased in some patients, probably because they were trying to lose weight during SOFT program. In the same way, despite of a significant loss of weight, there was no change in muscle and fat mass proportions after intervention. By the way reducing restriction was sometimes inducing increase of intakes in some patients, and as a result no change observed in average body fat mass and muscle mass. After intervention we also noticed that waist circumference, hip circumference and waist-hip ratio were significantly decreased, probably thanks to physical activity targeting posture and improving global physical condition. We observed also best performances in muscle strength (sit to stand test) and in endurance (6minutes walking test). Main limitations in this study were: a non-randomized non controlled study design; lack of long term assessment (which is very important for maintaining weight and avoid medical complications of overweighting) and no assessment of patient's quality of life after intervention as we think this is a great part of motivation to maintain long term changes of way of life. Despite these limitations, we hope that this program could be extended to all patients suffering from obesity and eating disorders with efficiency on eating behaviour. Changes in eating behaviour and in physical activity seem to be the first step to maintain weight at a long term perspective.

Association of Obesity with Peripheral Vascular Disease- A Case-control Study

Introduction: Peripheral Vascular Disease (PVD) is an important public health problem, due to its insidious course and the associated co-morbidities. Obesity has been implicated as one of the risk factor besides others. However, the reports on obesity are not consistent. Aim: To assess the association between central obesity and PVD along with other risk factors and the present study is undertaken to examine the correlation of central obesity as a risk factor for PVD. Further, the association between other risk factors and PVD was also ascertained. Materials and Methods: A total of 124 subjects were recruited in this case-control study. Ankle Brachial Index (ABI) was measured using peripheral Doppler studies. Patients with ABI &lt;0.9 were taken as cases and with ABI &gt;0.9 were taken as controls. Blood pressure was measured in the sitting position and the authors obtained anthropometric and demographic data. Chi-square test was used as the test of significance and p-value &lt;0.05 to be considered as level of significance. Results: Of the total 124 participants in the study, 62 participants were the cases and 62 participants were controls. Body Mass Index (BMI) was higher in cases with PVD but Waist Circumference (WC) and hip circumference were significantly lower (p-value=0.003 and &lt;0.001 respectively) and Waist-Hip Ratio (WHR) did not show any significant difference between cases and controls. Thus, fat mass is located elsewhere in these individuals, possibly it may be accumulated in the extremities. Other risk factors like history of smoking, history of alcoholism and history of diabetes mellitus had a positively significant association with PVD with p-values &lt;0.001, 0.023 and &lt;0.001 respectively. Conclusion: The results obtained from this data suggests that PVD is not associated with central obesity, instead it provides evidence that PVD correlates with peripheral fat mass. Subsequent studies separating central and peripheral obesity are required to get more clarity on the relationship between obesity and PVD.

Serum uric acid levels in type 2 diabetes mellitus among South Indian Urban Population: A cross sectional study

Background and aim: Hyperuricemia is common in individuals with obesity, metabolic syndrome and type 2 diabetes mellitus. This has been attributed to the hyperinsulinemia due to insulin resistance in T2DM and it’s effect on the renal excretion of uric acid. There have been recent studies depicting that hyperuricemia may independently predict the development of diabetes. However, there are conflicting studies of hypouricemia in T2DM as well which may be due to increased glomerular filtration rate with increased renal clearance of uric acid. In order to add further evidence to the existing database of knowledge about uric acid metabolism in T2DM this study was carried out. Material and Methods: This cross sectional study and the subjects were selected according to inclusion and exclusion criteria. Data recorded included serum uric acid, HbA1c, fasting and post prandial plasma glucose, serum creatinine, fasting lipid profile and waist hip ratio. Results: The mean value of serum uric acid was 5.11±1.2 mg/dL in diabetics and 4.59±1.12 mg/dL in non-diabetics, though within the normal reference range was statistically significant (p=0.029). However, the association of hyperuricemia (serum uric acid &gt;7mg/dL) as a risk factor for diabetes mellitus was not significant (p=1.000). Waist circumference in cases was 94.8 ± 10 cm and in controls it was 86.6 ± 11.6 cm (p&lt;0.001). Waist-hip ratio in diabetics was 1.0 ± 0.11 and in non-diabetics 0.9 ± 0.08 (p&lt;0.001). HbA1c, FBS, PPBS, serum creatinine, waist circumference, waist-hip ratio were significantly increased and HDLc was decreased significantly in diabetes mellitus. Conclusion: Increased serum uric acid, decreased HDLc and increased waist-hip ratio are observed in type 2 diabetes mellitus. Steps should be taken to monitor serum uric acid, lipid profile and anthropometric measurements of diabetics and non-diabetics.&#x0D; Keywords: Uric acid, type 2 Diabetes mellitus

Metabolic syndrome as a factor influencing the course of pregnancy

Background. According to the WHO guidelines, the criteria for metabolic syndrome (MS) include obesity (body mass index (BMI) &gt;30 kg/m2), abdominal obesity (ratio of waist circumference and hips circumference &gt;0.85 for females), blood pressure &gt;160/90 mm Hg, triglyceride level &gt;1.7 mmol/l, impaired glucose tolerance, microalbuminuria &gt;20 μg/min.&#x0D; Objective. To assess the impact of MS on pregnancy.&#x0D; Materials and methods. Analysis of literature data on this issue and our own study involving 38 obese women. Pregnant women in the study were tested for pregnancy-associated protein A (PAPP-A), placental growth factor (PIGF), arginine, and leptin. They were also prescribed a comprehensive preventive treatment (from 12 weeks of pregnancy – 150 mg of aspirin 1 g per day, from 16 weeks – L-arginine solution (Tivortin aspartate, “Yuria-Pharm”) 5 ml (1 g) 4 times per day for 2 months). The control group consisted of 30 healthy pregnant women, the comparison group – of 30 obese pregnant women who did not receive L-arginine.&#x0D; Results and discussion. The pathological consequences of the mother’s MS for the foetus are mediated by the insulin resistance, hyperglycemia, and vascular damage. The negative effects include birth injuries, caesarean section, childhood obesity, and cardiovascular disease. Eclampsia and preeclampsia (PE), which increase the risk of perinatal mortality, are also the important problems of modern obstetrics. The presence of obesity in pregnant women increases the likelihood of PE by 2-3 times. Pre-pregnancy BMI increase by 5-7 kg/m2 also doubles the risk. In addition to PE, obesity also increases the risk of gestational hypertension, premature birth, foetal growth retardation syndrome, macrosomia, gestational diabetes mellitus, sudden foetal death. Endothelial dysfunction (ED) is one of the main pathogenetic links of obstetric complications, primarily PE. Thus, hypertension in PE is a consequence of impaired endothelial control of vascular tone, proteinuria and oedema – of increased vascular permeability, coagulopathy – of overexpression of procoagulants. In obesity, the likelihood of PE increases as chronic inflammation and ED are induced. PE development is also mediated by the increase in the leptin concentration. Nitric oxide donors, namely L-arginine, should be prescribed to correct ED and prevent PE. According to the results of our own study, obese women in the first trimester had significantly higher leptin levels and significantly lower PIGF levels, which is a prerequisite for PE and other gestational complications. In the main group, compared to the comparison group, there was a lower frequency of early moderate PE (5 % vs. 8 %), early severe PE (1 % vs. 5 %), moderate PE after 34 weeks of pregnancy (8 % vs. 12 %), and severe PE after 34 weeks of pregnancy (1 % vs. 4 %).&#x0D; Conclusions. 1. Obesity significantly increases the risk of PE and other gestational complications. 2. The main mechanisms of adverse effects of obesity are chronic inflammation and ED. 3. The use of complex prophylaxis with aspirin and L-arginine for 2 months almost 5 times reduced the degree of severe early PE.