Waist-to-hip Ratio In Women Research Articles

Relation of mitochondrial DNA copy number and variants with the clinical characteristics of polycystic ovary syndrome

Mounting evidences suggests mitochondrial dysfunction as a novel contributor in the pathogenesis of PCOS. Herein, we analyzed mtDNA copy number, a biomarker of mitochondrial function in women with PCOS and non-PCOS participants and study its correlation with their clinical characteristics. In this study, we further analyzed association of 383 mtDNA variants, as reported previously by us, with characteristic traits of PCOS and perform structural analysis of mutated protein. Our results indicate relative mitochondrial DNA (mtDNA) copy number to be significantly reduced in women with PCOS compared to non-PCOS group and significantly inversely related to waist to hip ratio (WHR), triglycerides and positively related to high density lipoprotein-cholesterol (HDL-C). After adjustment of the age in the PCOS group, significantly negative correlation of mtDNA copy number with WHR was observed. Unsupervised hierarchical clustering analysis revealed rare, low heteroplasmic mtDNA variants such as 12556G, 1488T, 9200G, 9670G, 3308G, 14480G, 15914T and 5426G to be strongly associated with PCOS related traits. Among these variants, variant 12256G in ND5 gene affected both the flexibility and overall stability of the protein structure. This study is first to reveal significant correlation of mtDNA copy number with WHR in women with PCOS indicating link between mitochondrial dysfunction with central obesity in PCOS. we also first time showed association of rare mtDNA variants with characteristics traits of PCOS highlighting the clinical significance of rare mtDNA variants, which may cumulatively act as early predictors of risk of PCOS and its related comorbidities which may help in the management of PCOS.

Analysis of Waist-to-Hip and Height Ratio on the Risk of Cardiovascular Disease

Cardiovascular disease (CVD) remains a major global health issue affecting people of all ages, including those in their prime of life. Even though there are several risk factors for CVD, prevention depends on early identification. Moreover, Waist-to-Hip Ratio (WHR) and Waist-to-Height Ratio (WHtR) are predictors of cardiovascular disease that are easy to do and can be used for early detection of CVD. The aim of this study was to analyze the relationship between WHR and WHtR with the risk of CVD in the productive age group. The study used a cross-sectional design and purposive sampling involving 150 respondents aged 25-64. WHR and WHtR measurements as predictors and CVD risk scores were calculated using the Jakarta Cardiovascular Score (JCS). This study was analyzed with the Spearman's Rho test. The majority of women's WHR increased with low CVD risk, the majority of men's WHR increased with high CVD risk, and the majority of WHtR in both men and women increased with low CVD risk. There is a relationship between WHR and the risk of CVD with JCS in productive age (p=0.000, r = 0.535) and a relationship between WHtR and the risk of CVD with JCS (p=0.000, r = 0.332). The study suggests that WHR and WHtR are significant measurements in cardiovascular assessment to prevent cardiovascular disease in the productive age group.

The feasibility of anthropometric measurements for evaluation of abdominal obesity in patients with autosomal dominant polycystic kidney disease: A cross-sectional study.

Introduction: total kidney volume (TKV) increases in patients with autosomal dominant polycystic kidney disease (ADPKD), which perturbs anthropometric measurements. Objectives: the primary objectives were to investigate the accuracy of waist circumference (WC) and waist-to-hip ratio (WHR) for determining abdominal obesity in patients with ADPKD by comparison with magnetic resonance images. The secondary objectives were to investigate the associations of energy/macronutrient intake with WC and WHR. Methods: sixty patients with ADPKD were recruited from a nephrology outpatient clinic in this cross-sectional study. Main outcome measures were: TKV, total subcutaneous fat (TSF), total intraperitoneal fat (TIF), WC, WHR, body mass index (BMI), skinfold thickness (SFT), and energy/macronutrient intake. Results: mean age was 48.6 ± 11.3 years, 38 of 60 were women, median TKV was 1486 (IQR, 981-2847) mL. The patients classed as obese by the BMI had higher WC, TSF, TIF, and SFT than did non-obese; however, WHR was similar in obese and non-obese men. In the all-patients group, the WHR of obese and non-obese patients were also similar. TKV was positively correlated with WC and WHR in women, but not in men. In the multivariate analysis, TKV was an independent factor affecting WC and WHR in women. Dietary fat intake was similar in groups with and without abdominal obesity according to WC and WHR. Conclusions: in women with ADPKD, WC and WHR may not be accurate anthropometric measurements for evaluation of abdominal obesity; however, they may be associated with TKV.

Anthropometric measures and risk of all-cause and cardiovascular mortality: An 18 years follow-up

BackgroundThe contribution of anthropometric measures to predict mortality in normal-weight subjects is unclear. We aimed to study the association of central obesity measures, e.g., waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), with the risk of all-cause and CVD mortality. MethodsIn a prospective population-based Tehran Lipid and Glucose Study, 8287 participants aged ≥30 y, followed for a median of 18 years. The association of WC, WHR and WHtR with the risk for mortality was estimated using multivariate Cox proportional hazard models in different BMI groups. ResultsWe documented 821 deaths, of which 251 were related to CVD mortality. Normal weight individuals with central obesity were significantly at increased risk of all-cause (HR: 1.5; 95% CI: 1.10, 2.1) and CVD mortality (HR: 1.6; 95% CI: 0.92, 2.9) compared with normal-weight individuals without central obesity; the risk remained significant only in women. Also, normal-weight women (not men) with high WHR were at increased risk of all-cause (HR: 1.7; 95% CI: 1.0, 2.8) and CVD mortality (HR: 5.9; 95% CI: 1.5, 23.2). High WHtR increased the risk of all-cause (HR: 1.5; 95% CI: 1.2, 1.8) and CVD mortality (HR: 1.8; 95% CI: 1.2, 2.7) which remained significant in normal-weight men and women. All central obesity indicators were significantly associated with all-cause and CVD mortality in subjects aged under 65. ConclusionEven in normal-weight individuals, WC and WHR in women and WHtR in both sexes are predictors of all-cause and CVD mortality. WHtR shows a stronger association, especially in the population aged under 65.

Association between the serum estrone-to-estradiol ratio and parameters related to glucose metabolism and insulin resistance in women with polycystic ovary syndrome.

ObjectiveWe aimed to evaluate associations between the ratio of serum estrone (E1) to estradiol (E2) and parameters related to serum glucose metabolism and insulin resistance in women with polycystic ovary syndrome (PCOS).MethodsIn total, 133 women between the ages of 18 and 35 diagnosed with PCOS were enrolled in this study. All participants with PCOS underwent blood tests to determine hormonal and biochemical metabolic parameters and a standard 2-hour 75-g oral glucose tolerance test. They were divided into two groups according to the serum E1-to-E2 ratio: group 1 (E1/E2 ratio <2.0) and group 2 (E1/E2 ratio ≥2.0).ResultsIn the comparative analysis, the waist-to-hip ratio (WHR) was the only clinical variable that was significantly different between the two groups. Patients with a higher E1/E2 ratio showed higher fasting insulin levels, homeostasis model for insulin resistance, and postprandial glucose level at 2 hours (PPG2). In a correlation analysis, only PPG2 was significantly related to the serum E1/E2 ratio. However, after controlling for the confounding effects of body mass index (BMI) and WHR, fasting glucose was also significantly correlated with the serum E1/E2 ratio.ConclusionWomen with PCOS with a higher serum E1/E2 ratio were found to be more likely to show higher fasting insulin and postprandial glucose levels. Significant correlations were found between the serum E1/E2 ratio and both fasting and postprandial serum glucose levels after adjusting for BMI and WHR in women with PCOS.

The sex paradox in the interplay between periodontitis, obesity, and serum C-reactive protein: Data from a general population.

Women are generally periodontally healthier than men but they exhibit higher systemic levels of inflammatory markers. Our aim is to evaluate whether this paradox may be explained by different ramifications of adiposity or body shape. In 3,268 subjects from the Study of Health in Pomerania, we determined anthropometric and periodontal parameters, C-reactive protein (CRP), and fibrinogen as markers of inflammation. Behavioural and environmental risk factors and hand grip strength were assessed as factors interfering with the outcomes in question. We evaluated sex-specific associations of adiposity characteristics and periodontal variables such as probing depth (PD) with CRP and fibrinogen. After adjusting for age, waist-to-hip ratio (WHR), glycated hemoglobin, smoking, education, and grip strength, the opposite sex role of periodontitis and obesity on CRP levels were confirmed. WHR and body mass index (BMI) were associated with CRP in both men and women (P<0.001). CRP was associated with PD in men (P=0.001) but not in women (P=0.11). When adjusted for BMI this association was attenuated in men by 15% (P=0.002) but in women by 70% (P=0.58). PD was related to plaque and bleeding on probing (P<0.001) in both sexes and also to WHR in women (P=0.026) and men (P=0.002). BMI attenuated this association in women but not in men. HbA1c contributed significantly to PD in women (P=0.013) but not in men (P=0.76). Systemic CRP concentrations are affected by periodontitis and obesity in men. In women adiposity is more significant than in men overriding the impact of periodontal measures.

Ability of adiposity indicators to identify elevated high-sensitivity C-reactive protein in young adults

The aim of the present study was to compare the discriminatory ability of different adiposity indicators in distinguishing subclinical inflammatory levels in individuals 21 y of age. Data from the EPITeen (Epidemiological Health Investigation of Teenagers in Porto) population-based cohort (N = 1547) was analyzed. Body mass index (BMI), body fat percentage (BF%), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were ascertained to assess their relationship to high-sensitivity C-reactive protein (hs-CRP). Logistic regression models were fitted to examine the association of each adiposity indicator with elevated hs-CRP (≥75th sex-specific percentile). The areas under the curve (AUCs) of the receiver operating characteristic curves were calculated for all adiposity indicators to compare their relative ability to correctly classify individuals with elevated hs-CRP. After adjustment, all adiposity indicators were significantly associated with high hs-CRP in both sexes, except WHR in women (odds ratio, 1.15; 95% confidence interval [CI], 0.98-1.36). The magnitude of the associations was stronger in women. BMI presented the best discriminatory ability in women (AUC = 0.675; 95% CI, 0.632-0.717; cutoff values >22.6 kg/m2). In men, both BF% (AUC = 0.604; 95% CI, 0.557-0.651; cutoff values >18%) and WHtR (AUC = 0.604; 95% CI, 0.557-0.651; cutoff values >0.5) showed the best discriminatory ability. On the contrary, WHR showed the least ability to discriminate high hs-CRP in both sexes (AUC = 0.539; 95% CI, 0.489-0.584 for women and AUC = 0.574; 95% CI, 0.528-0.620 for men). WHR showed the least discriminatory ability for correctly identifying individuals with elevated hs-CRP. The small differences observed among the adiposity indices hinder the recommendation of a single best adiposity measure as predictor of low-grade inflammatory levels.

Mortality prediction of a body shape index versus traditional anthropometric measures in an Iranian population: Tehran Lipid and Glucose Study

ObjectivesA body shape index (ABSI) based on waist circumference (WC) adjusted for height and weight has been shown to be a risk factor for premature mortality. The aim of this study was to demonstrate that ABSI predicts mortality hazard better than other anthropometric measures in an Iranian population. MethodsThe study population included 9242 Iranian participants in Tehran, aged ≥30 y, followed for a median 10 y. The risk for mortality was estimated by incorporating ABSI, body mass index (BMI), WC, waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR), one at a time, into multivariate models as well as in terms of the effect size, calibration, discrimination, and added predictive ability. ResultsWe documented 487 deaths with the annual incidence rate of mortality per 1000 persons being 3.9 for women and 8.2 for men. ABSI was associated with all-cause mortality in a curvilinear fashion. ABSI was more strongly associated with all-cause mortality than were BMI, WC, and WHtR. Among women, however, WHpR was observed to be a stronger predictor of all-cause mortality than ABSI. Among both men and women, ABSI improved the risk classification based on other anthropometric measures, the only exception being WHpR. None of the anthropometric measures studied could add any value to the predictive ability of the Framingham's general cardiovascular disease algorithm. ConclusionABSI was the strongest predictor of all-cause mortality among the anthropometric measurements, except WHpR in women. When ABSI was added to the Framingham general cardiovascular disease algorithm, it failed to improve the predictive ability.

The discriminatory performance of body mass index, waist circumference, waist-to-hip ratio and waist-to-height ratio for detection of metabolic syndrome and their optimal cutoffs among Iranian adults.

The superiority of either of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) for prediction of metabolic syndrome (MetS) is remained controversial in Asian population. The objective of this study was to compare the discriminative capacity of either of these measures in prediction of non-adipose components of MetS. In this population-based cross sectional study, 1000 representative samples of adults were recruited in Babol, northern Iran. The demographic, anthropometric measures and blood pressure were determined by standard method. Fasting plasma glucose (FPG), triglycerides (TG), total cholesterol (CHL), high density lipoprotein (HDL) cholesterol levels were measured with enzymatic methods by an auto analyzer. The presence of two or more any of four non-obese components were considered as MetS. The diagnostic accuracies (AUCs) of four different measures were rather similar. While AUC for BMI (AUC=0.684; 95% CI: 0.633, 0.736) slightly tended to be higher than that of WC (AUC=0.640; 95% CI: 0.587, 0.693) and WHtR (AUC=0.649; 95% CI: 0.596, 0.701) in men but the accuracy of WC (equivalently WHtR (AUC=0.708; 95% CI: 0.664, 0.751) is tended to be greater than that of BMI in women. The optimal cut-off value for WC was higher in men compared with women. Overall, BMI, WC and WHtR were significant predictors of MetS equally but WC (equivalently WHtR) was a better predictor than BMI and WHR in women. The optimal cut-offs of WC are lower compared with western population for men but not for women.

Anthropometric indices predicting incident type 2 diabetes in an Iranian population: The Isfahan Cohort Study

BackgroundThe link between adiposity and type 2 diabetes (T2D) is well known. However, it remains controversial as to which index and cutoff point is the best predictor in different populations. MethodsA total of 2981 urban and rural Iranian adults over 35years of age, and free of cardiovascular disease and diabetes were followed for 7years. Anthropometric indices included body mass index (BMI), body adiposity index [BAI=(hip circumference/height1.5)–18], waist-to-height ratio (WHtR), waist-to-hip ratio (WHpR), and waist and hip circumferences. T2D was defined as fasting plasma glucose≥126mg/dL or 2-h post-prandial plasma glucose≥200mg/dL, or the use of antidiabetic agents. Receiver operating characteristic curve analysis determined the best cutoff point for each adiposity index. ResultsAfter 7years of follow-up, 389 new cases of diabetes were found. Most indices were linearly associated with increased risk of diabetes but the best continuous predictor was WHtR in men [odds ratio: 1.10 (95% confidence interval: 1.07–1.12) for one unit] and BMI in women [1.08 (1.04–1.11) for 0.1kg/m2]. BMI cutoffs of 26kg/m2 in men and 30kg/m2 in women were the best binary predictors in adjusted models, and showed increased T2D risks of 2.91 (2.06–4.12) and 1.94 (1.42–2.66) times, respectively. All central-obesity indices in men and WHpR in women were also significantly associated with T2D independent of BMI. BAI was significantly associated with T2D in men but not in women. ConclusionBMI at the appropriate cutoffs in both genders and WHtR in men and BMI in women as continuous factors were the best predictors of incident T2D in this Iranian population.

Judgments of Sexual Attractiveness: A Study of the Yali Tribe in Papua

Preferences for waist-to-hip ratio (WHR), sexual dimorphism in stature (SDS), and leg-to-body ratio (LBR) have been investigated predominantly in Western cultures. The aim of the present study was to examine the preferences of a relatively isolated, indigenous population (i.e., Yali of Papua, inhabiting the mountainous terrain east of the Baliem valley). A total of 53 women and 52 men participated in the study. Study sites differed in distance from Wamena, the biggest settlement in the region, and frequency of tourists’ visits. We found that the mate preferences among Yali men and women for WHR, LBR, and SDS were not exactly the same as in Western samples. Yali preferred low women’s WHR and relatively high women’s (but not men’s) LBR. Women’s and men’s ratings of each SDS set were similar, which suggests that the “male-taller norm” in Yali tribe was far weaker than in Western cultures. Additionally, the observed preferences were modified by contact with different cultures, age, and accessibility of food resources (pig possession). Our results suggest that human norms of attractiveness are malleable and can change with exposure to different environments and conditions.

References of anthropometric indices of central obesity and metabolic syndrome in Jordanian men and women

To set references and evaluate the associations between the predictive powers of the anthropometric indices of obesity, particularly central obesity, including body mass index (BMI), waist circumference (WC), waist to hip ratio (WHpR) and waist to height ratio (WHtR), and the risk factor accumulations of ≥ 2 of the components of the metabolic syndrome (MS) in a group of Jordanian men and women. Five hundreds subjects were randomly selected from among the visitors attending several family clinics in Amman. Obesity was assessed using BMI, WC, WHpR and WHtR anthropometric indices. MS risk factors as defined by the International Diabetes Federation were determined. Receiver operating characteristic curve (ROC) analysis was used to determine the predictive powers and the cut off points of each index associated with increased MS risk. There were 212 men and 288 women with age ranged 20-85 years. Optimal cut off points of BMI, WC, WHpR for MS diagnosis in men were 28.4 kg/m(2), 97.8 cm and 0.89, respectively. In women, these were 30.3 kg/m(2), 95.6 cm and 0.84, respectively. WHtR was 0.61 in both genders. Area under the curve (AUC) of ROC analysis for identifying of MS (≥ 2 risk factors) was the highest for WHpR (AUC=0.71), followed by WHtR (AUC=0.67), WC (AUC=0.64) and BMI (AUC=0.59) in men; whereas in women WHpR, WHtR and WC were almost equal (AUC=0.76, 0.75 and 0.74, respectively), followed by BMI (AUC=0.67). Correlation coefficients (r) between WHpR and MS risk factors were the strongest among the other obesity indices, followed by WC and WHtR. WHpR correlated significantly with FBG (r=0.27, p<0.01), systolic blood pressure (r=0.20, p<0.01), TGs (r=0.24, p<0.01) and HDL-C (r=-0.39, p<0.01). The respective r-values between WC and WHtR and each MS risk factors were: FBG (r=0.15, p<0.001 or r=0.13, p<0.01), systolic blood pressure (r=0.16, p<0.01 or r=0.11, p<0.05), TGs (r=0.20, p<0.01 or r=0.14, p<0.01) and HDL-C (r=-0.25, p<0.01 or r=-0.11, p<0.01). This study showed that BMI tended to be the weakest index for identifying MS risk factors in both sexes. WHpR exhibited the best predictive index for MS, particularly in men. Almost similar predictive powers of WHtR, WHpR and WC for identifying MS risk factors were seen in women. WHtR had the highest sensitivity for MS diagnosis among obesity indices in men and its boundary value was the same for both men and women. These cut off values of obesity particularly waist circumference should be advocated and used in Arab Jordanians until larger cross sectional studies shows different results.

The association of lifetime alcohol use with measures of abdominal and general adiposity in a large-scale European cohort

The relation between lifetime use of alcohol and measures of abdominal and general adiposity is unknown. Among 99,381 men and 158,796 women of the European Prospective Investigation into Cancer and Nutrition (EPIC) study, means of waist circumference (WC), waist-to-hip-ratio (WHR) and body mass index (BMI), and odds ratios (OR) for a larger WC than predicted for a given BMI (WClp=positive residuals of gender specific linear regression of BMI on WC) across categories of average lifetime use of alcohol (total, from wine and from beer) were calculated, all adjusted for socio-demographic, lifestyle and health factors. WC, WHR and BMI in men using lifetime ≤6 g/d alcohol were 95.1 cm, 0.942 and 27.3 kg/m(2), and 96.2 cm, 0.961 and 28.3 kg/m(2) when using >96 g/d. WC and WHR in women was 83.2 cm and 0.813 for ≤6 g/d, and 84.6 cm and 0.830 for >60 g/d, whereas BMI deviated only slightly with the lowest BMI (26.7 kg/m(2)) observed for >6-24 g/d. Compared with ≤6 g/d, OR for a WClp in both genders increased steadily across categories of alcohol use (up to 1.40 (95% confidence interval 1.32, 1.49) in men using >60 g/d and 1.63 (1.54, 1.73) in women using >24 g/d), though increase was higher for alcohol from beer than from wine (P for difference between beer and wine<0.001 (men) and=0.002 (women)). Lifetime alcohol use is positively related to abdominal and general adiposity in men, possibly following the male weight gain pattern; in women, it is positively related only to abdominal adiposity. In this context, beer may contribute additionally to abdominal adiposity.

Relationship of body mass index and waist-to-hip ratio with fibrinolytic activity measured as d-dimer

Increased coagulability or impaired fibrinolysis may partly explain how obesity increases cardiovascular disease risk. However, there has been some controversy regarding the relationship of anthropometric measures, like body mass index (BMI) and waist-to-hip ratio (WHR), and D-dimers. We aimed to determine the relationship of general and visceral obesity to D-dimer in a group of outpatients with different BMI and WHR ranges. We performed a cross-sectional study with adult patients from an outpatient primary health service. BMI, WHR and triceps skin fold were measured. Blood samples were collected from all patients and D-dimer levels were obtained. A total of 66 patients were included in the analysis. The patients had a mean age of 54.6 ± 15.3 years. Fifty-three (80.3%) patients were female and 13 (19.7%) were male. The mean BMI, WHR and triceps skin fold were 30.1 ± 6.9 kg/m(2), 0.88 ± 0.08, 20.9 ± 7.6 mm, respectively. For all the study group, D-dimers were positively correlated only with WHR (r = 0.27, p = 0.038). D-Dimers values were not related to BMI and to triceps skin fold. D-Dimers were moderately correlated with WHR in women (r = 0.40, p = 0.021), but not in male patients (r = 0.18, p = 0.601). Our results suggest that abdominal obesity may lead to disturbances in hemostasis, at least in female patients.

Association of heart rate recovery after exercise with indices of obesity in healthy, non-obese adults

We aimed at determining whether body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) are associated with heart rate recovery (HRR) and to demonstrate which of the three indices of obesity, is the strongest predictor of HRR in apparently healthy non-obese adults. Three hundred and twenty-five subjects aged 18-66 years participated in the study. Anthropometric indices were measured, and subjects performed cycle ergometer exercise at 75-85% maximum heart rate. Heart rate (HR) was measured during the last minute of exercise and in the first minute of post-exercise recovery. A partial correlation test and a multiple linear regression analysis, after adjusting for age and peak oxygen uptake indicated that the best predictors of HRR were BMI in males and WHR in females. The present data suggest that, HRR is independently related to indices of obesity-BMI, WC, and WHR and strengthen the usefulness of these anthropometric indices in predicting cardiovascular risks. In addition, the findings suggest that BMI in men and WHR in women best express the relationship between obesity and cardiovascular risks.

Dietary intervention in patients with metabolic syndrome: short- and long-term effects on abdominal obesity

Objective. To assess prospectively the short- and long-term effects of the calorie-reduced diet on anthropometric parameters, such as body-mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and compliance to the diet in men and women with metabolic syndrome (MS). Design and methods. 60 MS patients were enrolled according to IDF criteria (36 men) (average age 48  13 years). BMI at baseline was 33,4  4,9 kg/m2 in both sexes; WCmen = 113,9  10,9 cm, WCwomen = 108,8  10,1 cm; WHRmen = 1,01  0,05, WHRwomen = 0,99  0,07. All MS patients were insulin resistant (mean HOMA-IR = 5,8  3,6). Hypertension was diagnosed in 88,3 % (n = 53) MS patients according to the current guidelines. Mean blood pressure (BP) in men was 151,6  19,6/94,7  10,7 mmHg, BP in women was 161,4  22,4/96,0  10,3 mmHg. We compared anthropometric changes in two diet programs: short-term low-caloric diet in reduction of 500 kcal per day during 3 weeks supervised by hospital physicians; after that diet was home-based and completed by the participants on their own during 6 months period. Results. At 3 weeks, in supervised group there were signifi cant reductions in all anthropometric parameters in both sexes (p < 0,0003); however, men have achieved larger reduction in WC and WHR than women (baseline-3-weeks ƒWCmen = 4,38  1,7 cm vs ƒWCwomen = 3,7  2,0 cm; ƒWHRmen = 0,03  0,01 vs ƒWHRwomen = 0,027  0,01). At 6 month unsupervised patients had less WC and WHR reductions as compared to 3-week data (WCmen 112,1  10,7 cm vs 110,6  10,4 cm; WCwomen 103,0  6,9 cm vs 104,7  9,3 cm; WHRmen = 1,0  0,05 vs 0,99  0,05; WHRwomen = 0,96  0,05 vs 0,98  0,06). Compliance to the home-based diet was related to sex (women better than men) and was associated with greater reduction in WC and WHR in women. At 6 months home-based diet men had a signifi cant increase in abdominal obesity comparing to 3-week diet (difference 3-weeks-6-months WC = -1,44  2,9 cm in men, p = 0,02; difference WHR = -0,014  0,02, p = 0,003). Conclusion. In this prospective study supervised shortterm low-caloric program is more effective than home-based 6-months diet. We demonstrated the predictive value of gender in outcomes: men had greater reductions in WC and WHR in short-term supervised program, but due to the less compliance to the long-term home-based diet in males, women had greater reduction in WC and WHR after 6-months period.

Association of obesity with diabetic retinopathy: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SN-DREAMS Report no. 8)

The aim of the study was to report the prevalence of obesity indices in individuals with diabetes and find out their association with diabetic retinopathy in the urban Indian population. Subjects (n = 1,414) were recruited from Sankara Nethralaya Diabetic Retinopathy Epidemiology And Molecular Genetics Study (SN-DREAMS-I), a cross-sectional study between 2003 and 2006. Anthropometric measurements were carried out, and all patients' fundi were photographed using 45 degrees four-field stereoscopic digital photography. The diagnosis of diabetic retinopathy was based on the modified Klein classification. Generalized obesity and abdominal obesity were defined using WHO Asia Pacific guidelines with the BMI (body mass index) cutoff as > or =23 kg/m(2), WC (waist circumference) cutoffs as > or =90 cm in men and > or =80 cm in women and WHO guidelines using WHR (waist-to-hip ratio) cutoffs as > or =0.90 for men and > or =0.85 for women. Prevalence of obesity defined by BMI and WC was more in women compared to men, and that defined by WHR was more in men compared to women (P < 0.001). The prevalence of isolated generalized obesity, isolated abdominal obesity and combined obesity were 5.4, 10.1 and 58% in men and 4.5, 10.8 and 74.4% in women, respectively. The prevalence of any diabetic retinopathy and sight-threatening diabetic retinopathy was more in the isolated abdominal obesity group (26.35 and 6.08%, respectively) than in other subgroups. On logistic regression analysis, isolated abdominal obesity (OR 2.02, 95% CI: 1.06-3.86) and increased WHR in women (OR 1.48 95% CI: 1.10-2.38) were associated with diabetic retinopathy; BMI > or = 23 (OR 0.66, 95% CI: 0.48-0.90) and combined obesity (OR 0.72, 95% CI: 0.53-0.99) had a protective role for any diabetic retinopathy in the overall group. In the urban south Indian population, isolated abdominal obesity and higher WHR in women were associated with diabetic retinopathy, but not with the severity of diabetic retinopathy.

Overall Obesity and Abdominal Adiposity as Predictors of Mortality in U.S. White and Black Adults

The association of overall obesity and abdominal adiposity in predicting risk of all-cause mortality in white and black adults was compared. This prospective study included a national sample of 3219 non-Hispanic white and 2,561 non-Hispanic black adults 30 to 64 years of age enrolled in the third National Health and Nutrition Examination Survey during 1988-1994. Multiple measures of adiposity were measured and calculated, including body mass index (BMI), waist circumference, waist-to-hip ratio (WHR), and waist-to-thigh ratio (WTR). Vital status was ascertained with the National Death Index through 2000. During 12 years of follow-up (51,133 person-years), 188 white and 222 black adults died. After adjustment for age, education, smoking, and existing disease, positive dose-response associations between WTR and mortality in both sexes and races, and WHR in white and black women were observed (p(trend) < 0.05 for all). These results were unchanged after additional adjustment for BMI. In contrast, BMI and waist circumference alone exhibited curvilinear-shaped associations with mortality. A higher WTR was associated with a higher risk of mortality among normal weight (BMI: 18.5-24.9 kg/m(2)) and obese (BMI: > or =30.0 kg/m(2)) white and black adults. These results suggest ratio measures of abdominal adiposity, particularly WTR in both sexes and WHR in women, strongly and positively predict mortality, independent of BMI, among white and black adults. Furthermore, WTR offers additional prognostic information beyond that provided by BMI alone.

Seasonality, waist-to-hip ratio, and salivary testosterone

Patterns of seasonal variation in testosterone (T) and T-dependent measures are poorly understood in humans and particularly in women, despite their importance in other animals. We examined seasonal fluctuations in salivary T in women and men, and waist-to-hip ratio (WHR) in women. Participants were 220 women and 127 men from central and West Coast North America. Results showed that T was significantly highest in autumn for both women and men, and that WHR in women closely matched the seasonal variation in T, with high values in the fall and summer. This suggests that T does show a reliable fluctuation over the seasons, which may result in meaningful fluctuations in behavioral, cognitive, and somatic variables associated with T.

The Effects of a Multimodal Intervention Trial to Promote Lifestyle Factors Associated With the Prevention of Cardiovascular Disease in Menopausal and Postmenopausal Australian Women

The purpose of this study was to test the efficacy of a multimodal intervention (Women's Wellness Program) to improve women's cardiovascular risk factors. This 12-week randomized experiment with a control group targeted women 50–65 years living in the general population. Women in the intervention group were provided with a consultation with a registered nurse at which time biophysical cardiovascular risk measures were taken and health education was provided in both verbal and written form. Women were encouraged to review their smoking, nutrition, and water intakes and to commence an exercise program that included aerobic fitness exercises. Women in the control group continued their normal activities. The sample consisted of 90 women aged 50–65 years. Pre- and postintervention assessment utilized seven measures of cardiovascular risk factors: waist-to-hip ratio (WHR), body mass index (BMI), blood pressure, heart rate, weight, exercise levels, and smoking. Analysis of covariance indicated that the intervention was effective in improving women's aerobic exercise activity and decreasing smoking. The data from all five biophysical outcome measures supported the efficacy of the intervention, with significant decreases seen in the women's WHR, BMI, blood pressure, and measured weight. Study implications suggest that this type of intervention may provide an effective, clinically manageable therapy for women who prefer a self-directed approach to preventing and decreasing cardiovascular risk factors.