Waist-to-height Ratio Values Research Articles

Neck circumference, waist-to-height ratio, Chinese visceral adiposity index and incident heart failure

BackgroundThe indicators of abdominal obesity have shown to be associated with a high risk of cardiovascular diseases (CVDs), even adjusted for body mass index (BMI). We aimed to investigate the association between neck circumference, waist-to-height ratio (WHtR), Chinese visceral adiposity index (CVAI) and incident heart failure (HF) in Chinese adults.MethodsThe current study included 86,546 participants from two independent cohorts: the Kailuan I study established in 2006 and the Kailuan study II established in 2008. Participants aged 18–80 years who were free of CVDs or cancer were recruited at baseline. The values of neck circumference, WHtR and CVAI were available in 2014. The trajectory analysis was conducted using repeated measures of WHtR and CVAI in the 2008, 2010, 2012 and 2014 surveys. The incident HF cases were identified via reviewing medical records by cardiologists.ResultsDuring a mean follow-up of 5.62 years, 724 incident HF cases were documented. The highest quartiles of neck circumference, WHtR and CVAI respectively, were significantly associated with a high risk of HF compared to the lowest quartiles of adiposity measures (neck circumference: HR:1.30, 95%CI: 1.03–1.65; WHtR: HR:1.49, 95%CI: 1.16–1.92; and CVAI: HR:1.98, 95%CI: 1.48–2.65). The combination of adiposity measures with BMI or metabolic abnormalities jointly predicted incident HF. Presence of hypertension and diabetes appeared to be the major mediators, accounting for ∼ 8.11–24.7% of the associations between three indicators of abdominal obesity and HF risk.ConclusionThe new indices of abdominal adiposity could help to identify those who were at a high risk of HF, especially in the presence of high BMI or metabolic abnormalities.

Abstract 4126692: Effect of change in different adiposity indices over 10 years on Incident Type 2 Diabetes: The UK Whitehall II Study

Background: It is accepted that obesity increases type 2 diabetes risk. Some studies have explored associations between changes in body mass index (BMI) or waist circumference (WC), 2 indicators commonly used to assess obesity, and diabetes risk separately. However, there are few studies on the effect of change in waist-to-height ratio (WHtR), an index that has been suggested to be more strongly associated with diabetes than BMI and WC, on incident diabetes. Even fewer studies simultaneously examined the associations of change rate in the 3 indices with diabetes. Hypothesis: WHtR change may be more strongly associated with diabetes than BMI and WC. Aims: This study aims to investigate the change rates of BMI, WC, and WHtR in the UK adult population, and compare the effects of different adiposity indices’ changes on diabetes development. Methods: To make facilitate quantitative comparison of BMI, WC and WHtR, we used their standardized values. Repeated measures of the 3 indices were obtained from Phase 3 (1991-94), 5 (1997-99), and 7 (2002-04) of the UK Whitehall II Study (included persons participated in at least 2 of the 3 visits). Mixed effects model was used to calculate individual change rate of the 3 indices. Non-diabetic participants at Phase 7 were then followed up for incident diabetes until Phase 9 (2007-09). We examined the prospective association between change rate of the 3 indicators and diabetes by Cox regression analysis. Results: A total of 5,539 persons were included (mean age at Phase 3 was 49.6 years, 28.8% women). All adiposity indicators increased during Phase 3-7. The overall change rate of WHtR (0.07 SD/year) was higher than BMI (0.04 SD/year) and WC (0.06 SD/year). There were 375 non-diabetic (Phase 7) participants developing diabetes after a median follow-up period of 5.0 years. Initial WC value (HR:1.56) and WHtR value (HR:1.50) showed a stronger association with diabetes than initial BMI (HR:1.27). When the 3 indices increased at the same rate, WC change (HR:3.83, 95% CI: 2.48-5.93) had a higher risk of developing diabetes than changes in WHtR (HR:3.19, 95% CI: 2.19-4.64) and BMI (HR:2.57, 95% CI: 1.85-3.56). Conclusions: The rate of increase over time was higher in WHtR than BMI and WC in this UK adult population. Increases in WC and WHtR were more strongly associated with incident diabetes than BMI. When the 3 indices increased at the same rate, change in WC increased a higher risk of developing diabetes relative to BMI and WHtR.

Association of Age at Menarche with General and Abdominal Obesity in Young Women.

Background and Objectives: Age at menarche is related to various biological and socioeconomic factors in childhood. The aim of the study was to examine the association of age at menarche with general and abdominal obesity in young women. Materials and Methods: A transversal anthropometric survey was conducted with 102 females from 21 to 25 years of age. The surveyed traits included height, weight, waist circumference (WC) and hip circumference (HC). General obesity was assessed using the body mass index (BMI) and abdominal obesity by WC, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). A retrospective method was used for collecting age at menarche data. Results: The average age at menarche is 12.80 years. Early menarcheal age (<12 years) is detected in 25.5% of young females, while late onset of menarche (>14 years) is recorded for 20.6% of subjects. Early menarche age subjects exhibit significantly higher BMI, WC and WHtR in comparison with their late menarche age peers. There is a significant negative correlation between BMI, WC and WHtR values and menarcheal age. Late age at menarche is associated with higher probability of underweight status (BMI < 18.5 and/or WHtR < 0.4). Conclusions: Age at menarche has a negative correlation with general and abdominal obesity. Young women with early age at menarche show statistically higher values of BMI, WC and WHtR, while those with late menarcheal age show greater susceptibility to becoming underweight.

High Obesity Indices Are Associated with Gastroesophageal Reflux Disease, but Low Obesity Indices Are Associated with Peptic Ulcer Disease in a Large Taiwanese Population Study

Introduction: Gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD) are prevalent in Taiwan. Few studies have investigated the associations between obesity indices with GERD and PUD simultaneously. This study aimed to investigate the correlations among obesity indices with GERD and PUD in a large cohort of participants, around 120,000, in the Taiwan Biobank (TWB). Methods: A total of 121,583 participants (male: 43,698; female: 77,885; mean age 49.9 ± 11.0 years) were included to analyze the associations among obesity indices, including body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), abdominal volume index (AVI), lipid accumulation product (LAP), visceral adiposity index (VAI), and triglyceride-glucose index (TyG index), with GERD and PUD. Self-reported GERD and PUD were obtained by questionnaires. Multivariate logistic regression analysis was employed to analyze the relationship between obesity indices with GERD and PUD. Results: The prevalence of GERD and PUD was 13.7% and 14.6%, respectively. After multivariable analysis, high WHR (odds ratio [OR] = 1.009, p < 0.001), WHtR (OR = 1.005, p = 0.003), BRI (OR = 1.022, p = 0.005), AVI (OR = 1.013, p < 0.001), LAP (OR = 1.001, p < 0.001), TyG index (OR = 1.068, p < 0.001), and VAI (OR = 1.013, p = 0.002) were significantly associated with GERD, except BMI (p = 0.384). On the other hand, low BMI (OR = 0.984; p < 0.001) and AVI (OR = 0.994; p = 0.036) were significantly associated with PUD. However, the values of WHR (p = 0.151), WHtR (p = 0.304), BRI (p = 0.452), LAP (p = 0.799), VAI (p = 0.347), and TyG index (p = 0.642) were not. Conclusion: This study found that high obesity indices are associated with GERD, but low obesity indices are associated with PUD in a large Taiwanese population study. Our findings may alert physicians to notice that different obesity index may be associated with different gastrointestinal disorder.

Normoglycemia and type 2 diabetes: exploring secreted frizzled-4, insulin resistance, and waist-height ratio.

The current study was planned to compare serum levels of secreted frizzled related protein-4, insulin resistance and waist-to-height ratio in individuals with and without a diabetic background, and to assess the correlation of these markers with family history of diabetes. The cross-sectional comparative study comprised 80 subjects with confirmed normal glucose tolerance values. Parameters assessed included secreted frizzled related protein-4, fasting glucose, random glucose, fasting insulin, homeostasis model of assessment of insulin resistance and waist-toheight ratio values. Those without a diabetic background had significantly higher frizzled related protein-4 levels (p=0.02). Although subjects with family history of diabetes showed higher mean fasting glucose, waist circumference and waist-to-height ratio, these differences were not statistically significant (p>0.05). However, there was a strong positive correlation with waist circumference, waistto- height ratio, fasting insulin and homeostasis model of assessment of insulin resistance (p=0.0001). There was no significant correlation of diabetic background with frizzled related protein-4 SFRP-4, homeostasis model of assessment of insulin resistance and waist-to-height ratio (p>0.05).

Association between television viewing frequency and anthropometric indices among Peruvian women: Evidence from the 2019 demographic health survey

AimThis study aimed to evaluate the association between television viewing frequency and anthropometric indices in Peruvian women aged 15–49 years. MethodsA secondary analysis of the 2019 Demographic and Family Health Survey of Peru was conducted. Anthropometric measures related to increased cardio-metabolic risk, including body mass index (BMI), waist circumference (WC), Waist to Height Ratio (WHtR), and Conicity Index (CnI), were evaluated as outcomes. Television viewing frequency during a typical week (never [0 times per month]; occasionally [1 to 3 times per month]; and frequently [≥1 time per week]) was the exposure variable. Ordinal logistic regression analysis was performed considering confounding values as age, education level, current employment status, wealth index, residence area, region of residence, and current smoking status. ResultsA total of 13,249 women aged 15–49 years were included in the analysis. The prevalence of overweight and obesity was 39.3% and 25.0%, respectively. Watching television frequently increased the odds of being overweight or obese (aOR: 1.51; 95% CI: 1.07 to 2.12; p = 0.019), as well as having higher tertiles for WC (aOR: 1.57; 95% CI: 1.12 to 2.20; p = 0.008), WHtR (aOR: 1.59, 95% CI: 1.12 to 2.26; p = 0.010), and CnI (aOR: 1.47, 95% CI: 1.04 to 2.09; p = 0.031), compared to those who never watched television. ConclusionsA higher television viewing frequency was associated with obesity and increased values of WC, WHtR, and CnI. These insights underscore the potential impact of television habits on weight-related outcomes and provide valuable considerations for public health initiatives.

Association of waist-to-height ratio with sarcopenic obesity in hemodialysis patients with normal body mass index

Objective: To explore the association between waist-to-height ratio (WHtR) and sarcopenic obesity (SO) in maintenance hemodialysis (MHD) patients with normal body mass index (BMI). Methods: A multicenter and cross-sectional study that included adult patients undergoing MHD was conducted in 20 hemodialysis centers from June 1st to August 30th, 2021. Body composition was evaluated by body composition monitor based on bioimpedance spectroscopy. According to the quartiles of WHtR, patients were divided into four groups: Q1, Q2, Q3 and Q4 group. The association of WHtR with SO was determined by multiple logistic regression models, stratified analyses, interactive analyses, and receiver operating characteristic (ROC) analyses, respectively. Results: A total of 2 207 MHD patients (1 341 males and 866 females) were included, and aged [M (Q1, Q3)] 57 (44, 68) years. The prevalence of SO was increased with increasing quartiles of WHtR [8.6% (46/533), 22.5% (141/628), 35.4% (215/608), and 44.3% (194/438) for Q1, Q2, Q3, and Q4 group, respectively]. Multivariate logistic regression analysis showed that WHtR was associated with SO. The association remained statistically significant even after adjusting for age, gender, dialysis vintage, BMI, biochemical indicators, and various medical histories. Compared with Q1 group, the odds ratios (OR) were 2.54 (95%CI: 1.69-3.83), 4.30 (95%CI: 2.88-6.42) and 5.18 (95%CI: 3.37-7.96) for Q2, Q3 and Q4 group, respectively. The interaction analysis showed that age, sex and history of diabetes had interactive roles in the association between WHtR and SO (all P<0.05). The association stably existed across subgroups, and it was more obvious in male patients, those with older age and without a history of diabetes（all P<0.05）. Furthermore, the cut-off value of WHtR identifying SO in male patients was 0.49, and the corresponding area under the curve (AUC) was 0.73 (95%CI: 0.70-0.75), with the sensitivity of 72.7% and specificity of 60.3%. In female patients, the cut-off value was 0.51, and the AUC was 0.68 (95%CI: 0.65-0.71), with the sensitivity of 70.1% and specificity of 57.8%. Conclusion: WHtR could be used as a simple index to evaluate the risk of SO in MHD patients with normal BMI.

Abstract P139: Association Between Anthropometric Measurements and Diabetes and Their Abilities to Predict Diabetes: Based on the UK Whitehall II Study

Introduction: It is recognized that people with a high body mass index (BMI) will have a high risk of developing diabetes. However, some studies showed that other indices may provide a more accurate insight into the risk of developing diabetes. Our study aimed to compare the predictive abilities of 5 anthropometric measurements [BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist-by-height0.5 (WHT.5R), and a body shape index (ABSI)] for diabetes. Hypothesis: WHtR may be most strongly associated with diabetes. High WHtR but normal BMI persons may have higher risk for developing diabetes than persons with high BMI but normal WHtR. Methods: From the UK Whitehall II cohort, we included participants with full records of weight, height, and WC in Phase 3 (1991-1994) for baseline survey, and carried out follow-up survey in Phase 9 (2007-2009) for the non-diabetics of the baseline survey. Our study indices, BMI, WC, WHtR, WHT.5R, and ABSI, were calculated from measured weight, height, or WC. Based on the recognized cut-off value of BMI, WC, and WHtR, we classified the persons into normal group (BMI: &lt;25 kg/m 2 ; WC: &lt;90 cm for men and &lt;80 cm for women; WHtR: &lt;0.5) and abnormal group (≥ corresponding cut-off value). For the indices (WHT.5R and ABSI) without an accepted cut-off value, we selected the 75th cohort-wide centile as the cut point to divide the participants into normal group (WHT.5R &lt;75th cohort-wide centile; ABSI &lt;75th cohort-wide centile) and abnormal group (≥ corresponding cut-off value). Subgroup analyses were based on combination of BMI and WHtR (normal BMI + normal WHtR; high BMI + normal WHtR; normal BMI + high WHtR; high BMI + high WHtR). The outcome is diabetes. We studied predictive value of the indices to diabetes by receiver operator characteristic (ROC) curve analysis at baseline survey, and evaluated the association between the indices and diabetes by Cox regression analysis at follow-up survey. Results: A total of 7979 participants were included at baseline survey [mean age: 50.1 ± 6.0 years; 2468 (30.9%) females], and there were 7488 non-diabetics available for the follow-up survey. At baseline survey, ABSI [areas under the curve (AUC): 0.711, sensitivity: 77.0%, specificity: 55.5%] and WHtR (AUC: 0.709, sensitivity: 67.2%, specificity: 65.6%) had top 2 predictive value of diabetes. At follow-up survey, the abnormal group divided by cut-off value of WHtR had the highest hazard ratio (HR) (2.46; 95% CI: 2.06-2.93), while the abnormal group classified by ABSI cut-off value had the lowest HR (1.77; 95% CI: 1.45-2.15). In subgroup analyses, “normal BMI + high WHtR” group (HR: 2.28; 95% CI: 1.59-3.27) appears to have higher risk for developing diabetes than “high BMI + normal WHtR” group (HR: 1.63; 95% CI: 1.22-2.17). Conclusion: WHtR seems to be an effective indicator for predicting diabetes. Besides BMI, controlling WHtR to the normal range is important for the prevention of diabetes.

СLINICAL CHARACTERISTICS OF CHILDREN AND ADOLESCENTS WITH METABOLIC SYNDROME IN KYIV

This study aimed to clinically evaluate children and adolescents with metabolic syndrome (MetS) in order to identify and diagnose the condition at an early stage and prevent possible complications.&#x0D; Materials and Methods. A comprehensive examination of 105 children aged 10 to 17 years with MetS was conducted at the Rheumatology and Cardiology Department of Children's Clinical Hospital No. 6 in Kyiv. The International Diabetes Federation (IDF) criteria were used to establish MetS. Anthropometric assessments included calculation of body mass index, evaluation of waist circumference using age-specific percentile charts, determination of waist-to-height ratio (WHtR), and measurement of neck circumference in lying and standing positions. Ambulatory blood pressure monitoring was performed using the ABM-04 device (Meditech, Hungary), and laboratory investigations (glucose, insulin, lipid profile) were conducted using the Cobas 6000 analyzer and test system (Roche Diagnostics). The EZR version 1.61 (November 11, 2022) package was used for statistical analysis of the obtained data.&#x0D; Results and Discussion. In terms of heredity analysis, the presence of hypertension in the father of children, maternal grandmother, and mother was the most common, indicating the importance of genetic influence on the development of this condition. Among the most common complaints were elevated blood pressure, headaches, anxiety, and palpitations. The logistic regression model demonstrated that daytime sleepiness was associated with symptoms such as sweating, morning hoarseness, tinnitus, weather sensitivity, and fatigue. There was no statistically significant difference between the manifestations of acanthosis nigricans and purple stretch marks in girls and boys, but a higher tendency was observed in males.&#x0D; Conclusions. Metabolic syndrome in children and adolescents is associated with a high risk of complications, as most of them have a high WHtR value. Cardiovascular diseases showed the highest hereditary dependency in close relatives of children with MetS. Cardiovascular symptoms are the most common among children with MetS, but girls had significantly higher frequencies of emotional and psychological symptoms.

Diagnostic Accuracy of Waist-to-Height Ratio, Waist Circumference, and Body Mass Index in Identifying Metabolic Syndrome and Its Components in Older Adults: A Systematic Review and Meta-Analysis

BackgroundAlthough numerous studies have indicated the utility of waist-to-height ratio (WHtR) in early screening for individuals with adverse cardiometabolic health, there is controversy on using WHtR as a one-size-fits-all approach, including in older adults. ObjectivesOur study aims to identify the pooled diagnostic accuracy of WHtR in screening for metabolic syndrome (MetS) and its components among older adults. MethodsA systematic review of observational studies was performed using 4 databases. A diagnostic meta-analysis with a random effects model was conducted, and the pooled area under the summary receiver operating characteristic curve, sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio (dOR) of each outcome compared with WHtR, body mass index (BMI), and waist circumference (WC) were calculated, with sex-stratified analysis. ResultsA total of 17 studies with 74,520 participants were included. As reflected by the dOR, WHtR (7.65; 95% CI: 6.00, 9.75) performed better than BMI (5.17; 95% CI: 4.75, 5.62) and WC (5.77; 95% CI: 4.60, 7.25) in screening for MetS among older adults and was potentially better among males. For hyperglycemia, hypertension, and dyslipidemia, the performances of WHtR, BMI, and WC were comparable. ConclusionMore studies focusing on older adults are still needed to determine the cutoff values of WHtR to screen for MetS.The search strategy was registered in PROSPERO as CRD42022350379.

The Potential use of Anthropometric Parameters to Predict the Anemia Status of Adolescent Girls

The study assesses the potential use of anthropometric parameters and their optimal cut-off value for predicting the anemia status of adolescent girls. This cross-sectional study analyzed data from 2,184 adolescent girls aged 15‒19 years from West Bandung and Sumedang districts of Indonesia who participated in the Better Investment for Stunting Alleviation Program (BISA). Anemia is defined as a Haemoglobin (Hb) level &lt;12 g/dl and was analyzed by HemoCue® 201+. Anthropometric parameters studied were Body Weight (BW), BMI-for-Age z-Score (BAZ), Waist Circumference (WC), Waist-to-Hip Ratio (WHR), and Waist-to-Height Ratio (WHtR) and all were measured according to WHO procedure. Receiver Operating Characteristics (ROC) was used to analyze the potential of anthropometric parameter to predict anemia status. Based on multivariate analysis, a significant correlation was found between age (OR=0.88; 95% CI:0.79‒0.97) and WHtR (OR=0.12; 95% CI:0.02‒0.63) with anemia status. The ROC analysis revealed that the WHtR parameter had the highest Area Under the Curve (AUC) for predicting anemia, although with a very low accuracy (AUC=0.529). The optimal cut-off with value of WHtR for adolescent girls was ≤0.44. This study suggests that WHtR is a potential parameter for early detection of anemia status among adolescent girls and needs to be confirmed with further studies.

Early evaluation of waist-to-height ratio for the prediction of worsening acute pancreatitis.

The purpose of this study was to evaluate the association between the waist-to-height ratio (WHtR) and the aggravation of acute pancreatitis (AP). This prospective study included AP patients treated from May 2019 to December 2019 in the Department of Gastroenterology, the First Affiliated Hospital of Nanchang University. Receiver operating characteristic curves were constructed to determine the optimal threshold values for predicting the aggravation of AP. Risk factor analysis was performed via logistic regression analysis. Of 258 patients included in this study, 77 (29.84%) were diagnosed with mild acute pancreatitis, 120 (46.51%) with moderately severe acute pancreatitis, and 61 (23.64%) with severe acute pancreatitis (SAP). WHtR, waist circumference, weight, and body mass index were all associated with AP severity, and the highest area under the receiver operating characteristic value was observed for WHtR. The optimal threshold WHtR value for predicting SAP was 0.567. Multivariate logistic regression analysis identified WHtR ≥ 0.567 as independent risk factor for SAP. Moreover, the hospital stay was longer and intensive care unit admission rate was higher among AP patients with a WHtR ≥ 0.567. The WHtR was found to be closely related to the severity of AP and an independent risk factor for the aggravation of AP. This simple parameter can aid the early prediction of AP progression, thereby facilitating early intervention and improving patient outcomes.

Waist-to-height ratio assessment device

Many diseases are associated with excess abdominal fat like cardiovascular diseases. Monitoring and controlling abdominal fat led to one of the many factors that can change the status of a person’s health. Awareness of the waist-to-height ratio (WHtR) can be a guide to adjusting to a person’s lifestyle and maintaining a normal WHtR value. This study developed the WHtR assessment device that automatically calculates the WHtR value, displays the health status, and suggests the ideal waist circumference. The device is composed of a microcontroller that interconnects the other components of the device. A touchscreen liquid crystal display component was used as an input and output unit at the same time. The several testing that was conducted revealed accurate WHtR value calculation. The device is effective in assessing the health status of all age groups. The ideal waist circumference from the device was compared to manual computation and found that the success rate is one hundred percent (100%).

Diagnostic performance of different anthropometric indices among Iranian adolescents for intima media thickness in early adulthood: A prospective study and literature review.

There is debate regarding which anthropometric indices is the most appropriate predictor of cardiovascular disease (CVD) among adolescents. The purpose of this study was to investigate the association of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) in adolescents with high carotid intima-media thickness (cIMT) in early adulthood, as the surrogate marker of CVD in a cohort study. A total of 875 Iranian adolescents (female = 421) aged 10-17 years old were entered the study. The cIMT was measured in early adulthood (20-38 years old) after 18.2 (median) years of follow-up and defined as > 90th percentile for sex and age groups. The gender specific association between a 1-SD increase in each anthropometric measures with high cIMT was examined using multivariate logistic regression analysis adjusted for age, smoking, family history of CVD, systolic blood pressure, total cholesterol, and fasting blood sugar. In the multivariable analysis, the interaction between sex and age groups with anthropometric measures were significant (all p-values < 0.05). Among males, all anthropometric measures including BMI, WC, WHR, and WHtR were associated with high cIMT; the corresponding odds ratios were 1.43 (1.05-1.94), 1.63 (1.22-2.19), 1.33 (1.03-1.71), and 1.41 (1.07-1.87), respectively. However, after considering the related adulthood anthropometric measurements, the association remained significant for WC 1.48 (1.04-2.10) and WHR [1.28 (0.99-1.66), P = 0.06]. Moreover, among early adolescent boys aged 10-14 years, all of the anthropometric measures were significantly associated with high cIMT in the multivariate analysis that included the related adulthood anthropometric measures. The area under the curve (AUC) for the anthropometric measurements among males ranged from 0.576 for WHtR up to 0.632 for WC, without any superiority between them. Among females, only in linear regression analysis, a significant association were found between the higher value of WC and WHtR with cIMT measurement in adulthood; however, the risk reached to null after considering adult anthropometric measures. General and central obesity measures were significantly associated with high cIMT only among Iranian male adolescents, the relationship that were more prominent among pre-pubertal males.

High free leptin index as the risk factor for childhood obesity in Indonesia: A case-control study.

Identifying the risk factors is critical in preventing childhood obesity. Leptin concentration is elevated in obesity. High serum leptin levels are believed to reduce soluble leptin receptor (sOB-R) concentrations and are associated with leptin resistance. The free leptin index (FLI) is a biomarker of leptin resistance and the status of leptin action. This study aims to investigate the association between leptin, sOB-R, and FLI with measurements to diagnose obesity in children, such as BMI, waist circumference and waist-to-height ratio (WHtR). We conducted a case-control study in 10 elementary schools in Medan, Indonesia. The case group was children with obesity, while the control group was children with normal BMI. Leptin and sOB-R levels were measured from all the subjects using the ELISA method. Logistic regression analysis was employed to determine which factors were predictor variables of obesity. A total of 202 children between 6 and 12 years old were recruited for this study. Children with obesity showed significantly higher leptin levels and FLI and lower SOB-R levels FLI (p < .05) than control. The cut-off for WHtR in this study was 0.499 (sensitivity 90% and specificity 92.5%). Children with higher leptin levels had a higher risk of obesity based on BMI, waist circumference, and WHtR values.

IMPACT OF BODY FAT DISTRIBUTION, ADIPOCYTOKINES AND VARIABILITY IN ASSOCIATED GENES ON KIDNEY TRANSPLANT OUTCOMES

Objective: Adiposity distribution contributes to a number of pathologies. We aimed to assess whether this distribution was associated with clinical outcomes and to identify its relationship with leptin and adiponectin gene variants and plasma concentrations in renal transplant recipients (RTR). Design and method: Anthropometric parameters were measured in 236 RTR by bioelectrical impedance analysis, allograft function and post-transplant complications were retrieved from records. Blood samples were drawn to measure plasma leptin/adiponectin levels and to seek for polymorphisms in the leptin receptor (LEPR) and adiponectin (ADIPOQ) genes. Logistic regression models were applied to identify associations. Results: The waist-to-height ratio (WHr) displayed a significant association with delayed graft function (DGF), acute rejection (AR) and post-transplant diabetes mellitus, with OR values of 2.04 (1.02–4.08) p = 0.045; 3.08 (1.22–7.79) p = 0.017 and 2.79 (1.16–6.74) p = 0.022, respectively. Waist circumference was linked to DGF [OR = 1.03 (1.01 – 1.053), p = 0.025] and AR [OR = 1.041 (1.01 – 1.073), p = 0.009]. Leptin levels were significantly higher in patients who experienced AR [19.91 ± 23.72 vs. 11.22 ± 16.42 ng/ml; OR = 1.021 (1.01–1.04), p = 0.017]. The ADIPOQ rs1501299TT genotype showed a significant association with higher WHr (0.63 ± 0.11 vs. 0.59 ± 0.87 for GG/GT genotypes; p = 0.015) and WC values (102.3 ± 14.12 vs. 96.38 ± 14.65 for GG/GT genotypes; p = 0.021). Conclusions: We have shown that WC, and especially WHr, are associated with adverse outcomes in renal transplant and hence may be useful parameters in RTR monitoring. In turn, these anthropometric parameters were affected by variability in the ADIPOQ gene, suggesting this polymorphism could be a useful marker of transplanted patients at risk.

Body composition and functional performance of older adults

ObjectivesTo determine if anthropometric variables, body composition, medication and gender are associated with functional performance and to compare these variables between octogenarians with high and low functional performance. MethodsObservational, cross-sectional study. Weight, height, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) were evaluated. Handgrip strength (HGS) was assessed. Participants’ body composition was assessed by dual-energy X-ray absorptiometry (DXA) and functional performance by Short Physical Performance Battery (SPPB). A binomial logistic regression was performed. ResultsOne hundred and twenty-two octogenarians were included and separated into high and low function groups. The high function group showed lower values of WHtR (mean difference [MD] = 0.047, P = 0.025) and body fat (BF%) (MD = 3.54, P = 0.032) and higher values of apendicular skeletal muscle mass (ALM) (MD = 3.03, P = 0.001), HGS (MD = 6.11, P = 0.001) and SPPB score (MD = 4.20, P = 0.001). Women were more likely to be classified as low function (OR = 3.66, P = 0.002) and males showed 5.21 odds ratio (P = 0.021) of having high functional performance compared to females. Also, each decrease in age and medication use displayed 1.30 (P = 0.007) and 1.26 odds ratio increases (P = 0.008) in high functional performance. ConclusionsOlder males display better functional performance than women, and decrements in age and medications increase the high functional performance odds ratio. Octogenarians with high functional performance displayed lower BF measurements and higher values of muscle mass and strength.

Metabolic Syndrome and High-Obesity-Related Indices Are Associated with Poor Cognitive Function in a Large Taiwanese Population Study Older than 60 Years.

Metabolic syndrome (MetS) is prevalent in Taiwan; however, the association between MetS and cognitive function is unclear. The aim of this study was to explore the associations between MetS, its components, and obesity-related indices with cognitive function in a large Taiwanese cohort. We enrolled a total of 28,486 participants who completed the Mini-Mental State Examination (MMSE) questionnaire, which was used to evaluate cognitive function. MetS was defined according to the NCEP-ATP III guidelines and modified criteria for Asians. Ten obesity-related indices were also evaluated: body mass index (BMI), abdominal volume index (AVI), body adiposity index (BAI), waist–hip ratio (WHR), a body shape index (ABSI), lipid accumulation product, waist-to-height ratio (WHtR), conicity index (CI), body roundness index (BRI), and triglyceride glucose index. The prevalence of MetS and its components (except for hypertriglyceridemia) and the number of MetS components increased while the cognitive impairment worsened (from MMSE ≥ 24, 18–23 to 0–17). In addition, increases in all obesity-related index values were associated with a decline in cognitive function (from MMSE ≥ 24, 18–23 to 0–17, ANOVA p < 0.001). Multivariable analysis showed that MetS (p = 0.002), abdominal obesity (p < 0.001), low high-density lipoprotein cholesterol (p = 0.004), and hyperglycemia (p = 0.012) were significantly associated with a low MMSE score. Further, participants with high BMI (p = 0.001), WHR (p < 0.001), WHtR (p < 0.001), BRI (p < 0.001), CI (p < 0.001), BAI (p < 0.001), AVI (p < 0.001), and ABSI (p < 0.001) values were significantly associated with a low MMSE score. Our results show that MetS and its components (except for hypertriglyceridemia and high blood pressure) may lead to cognitive impairment, and that high values of obesity-related indices were associated with poor cognitive function.

Body Fat Distribution, Adipocytokines Levels and Variability in Associated Genes and Kidney Transplant Outcomes.

Introduction: Body fat distribution is known to contribute to a variety of pathologies. Research Questions: We aimed to assess whether this distribution is associated with clinical outcomes in renal transplant recipients (RTR) and to examine its relationship with leptin and adiponectin gene variants and plasma concentrations. Design: Bioelectrical impedance analyses were performed in 236 RTR. Leptin/adiponectin levels were measured by immunoassay and relevant polymorphisms in the leptin receptor (LEPR) and adiponectin (ADIPOQ) genes were identified. Associations were assessed by logistic regression modeling. Results: The waist-to-height ratio (WHr) displayed a significant association with delayed graft function, acute rejection and post-transplant diabetes mellitus, with OR values of 2.04 (1.02-4.08) p = 0.045; 3.08 (1.22-7.79) p = 0.017 and 2.79 (1.16-6.74) p = 0.022, respectively. Waist circumference was linked to delayed graft function [OR = 1.03 (1.01-1.05), p = 0.025] and AR [OR = 1.041 (1.01-1.07), p = 0.009]. Leptin levels were significantly higher in patients who experienced rejection [19.91 ± 23.72 versus 11.22 ± 16.42 ng/ml; OR = 1.021 (1.01-1.04), p = 0.017]. The ADIPOQ rs1501299TT genotype showed a significant association with higher WHr (0.63 ± 0.11 vs 0.59 ± 0.87 for GG/GT genotypes; p = 0.015) and WC values (102.3 ± 14.12 vs 96.38 ± 14.65 for GG/GT genotypes; p = 0.021). Conclusion: WC, and especially WHr, are associated with adverse outcomes in renal transplantation and are affected by variability in the ADIPOQ gene.

Assessment of Future Hypertension Risk by Sex Using Combined Body Mass Index and Waist-to-Height Ratio.

Background: Body mass index (BMI) and the waist-to-height ratio (WHtR) are widely used anthropometric indices of obesity to predict cardiovascular risks. However, the usefulness of combining WHtR and BMI values to predict hypertension risk by sex has not been well elucidated. Methods and Results: This cohort study enrolled 45,921 participants (mean [±SD] age 53.8±10.5 years; 47.0% men) without hypertension from among those undergoing annual health checkups. Participants were divided into 4 categories based on median BMI and WHtR values, and the 5-year incidence of hypertension was assessed for both sexes using logistic regression analysis. Mean (±SD) BMI and WHtR values were 23.5±3.1 kg/m2 and 0.50±0.05, respectively, in men and 22.4±3.3 kg/m2 and 0.53±0.06, respectively, in women. Among the women, those with high BMI and low WHtR had an increased risk of hypertension compared with those with low BMI and low WHtR (odds ratio [OR] 1.37, P<0.001); however, the same result was not found in men (OR 1.14, P=0.080). In both sexes, the incidence of hypertension was higher among participants with low BMI and high WHtR than among those with low BMI and low WHtR (men: OR 1.26, P<0.001; women: OR 1.15, P=0.048). Conclusions: Using WHtR and BMI together provides a better hypertension risk assessment. Among men, those with a high BMI had no increased hypertension risk when WHtR was low.