Waist circumference provides an indication of numerous cardiometabolic risk factors in adults with cerebral palsy

This article has been made available through the Brunel Open Access Publishing Fund.Objective: To report the prevalence of cardiometabolic risk factors in a cohort of adults with cerebral palsy (CP) and to investigate the ability of anthropometric measures to predict these factors. Design: Cross-sectional study. Setting: Testing took place in a laboratory setting. Participants: Adults with CP (NZ55; mean age, 37.5 13.3y; Gross Motor Function Classification System levels, IeV) participated in this study. Interventions: Not applicable. Main Outcome Measures: Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, insulin, and C-reactive protein levels were measured from a fasting venous blood sample. Insulin resistance was calculated using the Homeostasis Model Assessment (HOMA-IR) index. Blood pressure, body mass index (BMI), waist circumference (WC), waist-hip ratio, and waist-height ratio were also measured. The metabolic syndrome (MetS) was defined according to the 2009 Joint Interim Statement. Results: The prevalence of the MetS was 20.5% in ambulatory adults and 28.6% in nonambulatory adults. BMI was associated with HOMA-IR only (bZ.451; P<.01). WC was associated with HOMA-IR (bZ.480; P<.01), triglycerides (bZ.450; P<.01), and systolic blood pressure (bZ.352; P<.05). Receiver operating characteristic curve analysis revealed that WC provided the best indication of hypertensive blood pressure, dyslipidemia, HOMA-IR, and the presence of multiple risk factors (area under the curve, .713e.763). Conclusions: A high prevalence of the MetS was observed in this relatively young sample of adults with CP. WC was a better indicator of a number of risk factors than was BMI and presents as a clinically useful method of screening for cardiometabolic risk among adults with CP

Evaluation of waist-to-height ratio to predict 5 year cardiometabolic risk in sub-Saharan African adults

Simple, low-cost central obesity measures may help identify individuals with increased cardiometabolic disease risk, although it is unclear which measures perform best in African adults. We aimed to: 1) cross-sectionally compare the accuracy of existing waist-to-height ratio (WHtR) and waist circumference (WC) thresholds to identify individuals with hypertension, pre-diabetes, or dyslipidaemia; 2) identify optimal WC and WHtR thresholds to detect CVD risk in this African population; and 3) assess which measure best predicts 5-year CVD riskPeer reviewedFinal Accepted Versio

Diagnostic performance of waist-to-height ratio in identifying cardiovascular risk factors and metabolic syndrome among adult Saudis. A cross-sectional study

Objectives: To evaluate the diagnostic performance of waist to height ratio (WHtR) to screen for cardiovascular risk factors (CVRF) and metabolic syndrome (MetS) among Saudis. Methods: Between June 2013 and August 2014, a cross-sectional study of 3,063 adult Saudis of both genders from King Khalid Hospital, Riyadh, Saudi Arabia was conducted. Using the “WHO STEPwise Surveillance-Instrument V2.1”, which uses sequential steps including questionnaires and anthropometric and biochemical measurements of MetS and CVRF. Waist to height ratio validity in defining central obesity, MetS, and CVRF were tested using receiver operating characteristic curve (ROC), sensitivity, specificity, positive and negative predictive values, and accuracy. Using multivariate regression analyses for adjustment of confounders as age and gender were applied to compute adjusted odds ratios (aOR). Results: The diagnostic potential of WHtR was excellent for central obesity (area under the curve [AUC] = 0.98), and MetS (AUCs = 0.86); it was good for CVRF ≥2 (AUCs = 0.79) and was satisfactory for dyslipidemia (AUCs = 0.66). The sensitivities and negative predictive values exceeded 85% for diagnosing central obesity, diabetes, and hypertension. Adjusted odds ratios for age and gender showed that WHtR ≥0.50 significantly increased the risk of diabetes, hypertension, and ≥2 CVRF by almost 4-fold, and increased the risk of dyslipidemia by 2-fold. Conclusion: Waist height ratio showed a good diagnostic performance for CVRF and MetS among Saudis. Furthermore, WHtR ≥0.5 increased the risk of dyslipidemia, diabetes mellitus and hypertension

Validation of Surrogate Anthropometric Indices in Older Adults: What Is the Best Indicator of High Cardiometabolic Risk Factor Clustering?

The present study evaluated the ability of five obesity-related parameters, including a body shape index (ABSI), conicity index (CI), body roundness index (BRI), body mass index (BMI), and waist-to-height ratio (WtHR) for predicting increased cardiometabolic risk in a population of elderly Colombians. A cross-sectional study was conducted on 1502 participants (60.3% women, mean age 70 7.6 years) and subjects’ weight, height, waist circumference, serum lipid indices, blood pressure, and fasting plasma glucose were measured. A cardiometabolic risk index (CMRI) was calculated using the participants’ systolic and diastolic blood pressure, triglycerides, high-density lipoprotein and fasting glucose levels, and waist circumference. Following the International Diabetes Federation definition, metabolic syndrome was defined as having three or more metabolic abnormalities. All surrogate anthropometric indices correlated significantly with CMRI (p < 0.01). Receiver operating characteristic curve analysis of how well the anthropometric indices identified high cardiometabolic risk showed that WtHR and BRI were the most accurate indices. The best WtHR and BRI cut-off points in men were 0.56 (area under curve, AUC 0.77) and 4.71 (AUC 0.77), respectively. For women, the WtHR and BRI cut-off points were 0.63 (AUC 0.77) and 6.20 (AUC 0.77), respectively. In conclusion, BRI and WtHR have a moderate discriminating power for detecting high cardiometabolic risk in older Colombian adults, supporting the idea that both anthropometric indices are useful screening tools for use in the elderly.This study is part of a larger project that has been funded by the Colciencias y Ministerio de Salud y la Protección Social de Colombia (The SABE Study ID 2013, no. 764)

Upotreba antropometrijskih obilježja debljine u procjeni mikrovaskularnih komplikacija u pretilih bolesnika s tipom 2 šećerne bolesti

Waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) are superior to body mass index (BMI) in predicting type 2 diabetes mellitus (T2DM) development. The aim of this study was to investigate the predictive power of BMI, WC, WHR and WHtR for microvascular (chronic kidney disease (CKD), retinopathy and peripheral neuropathy) prevalence in obese (BMI ≥35 kg/m2) T2DM patients. This cross-sectional study included 125 T2DM patients of both genders. The validity of each test was assessed by Receiver Operating Characteristic (ROC) curves; the area under the curve (AUC) was calculated for each anthropometric parameter and microvascular complication. AUCs for WHtR were significantly higher than AUCs for WC with respect to CKD. Optimal cut-off for WHtR was >0.593 and WC >112 cm regarding CKD. The AUC for peripheral neuropathy was significant only for WHR and optimal cut-off for WHR was >1.409 with low sensitivity and high specificity. Our study demonstrated that WHtR, WC and WHR might be used as simple and noninvasive methods for detection of CKD and peripheral neuropathy in obese T2DM population.Opseg struka (OS), omjer opsega struka i bokova (OSB) i omjer opsega struka i visine (OSV) su bolji predskazatelji razvoja šećerne bolesti tipa 2 (ŠB2) nego široko upotrebljavani indeks tjelesne mase (ITM). Svrha ovoga istraživanja je bila istražiti učinkovitost ITM, OS, OSB i OSV u procjeni učestalosti mikrovaskularnih komplikacija (kronična bubrežna bolest (KBB), retinopatija i periferna neuropatija) u pretilih (ITM ≥35 kg/m2) bolesnika sa ŠB2. Ova presječna studija je uključila 125 bolesnika oba spola sa ŠB2. Dijagnostička vrijednost testova je procijenjena krivuljama ROC (engl. Receiver Operator Characteristic); područje ispod krivulje (AUC) je izračunato za svaki antropometrijski parametar i rizični čimbenik (mikrovaskularnu komplikaciju). AUC za OSV je bio značajno viši nego AUC za OS za KBB. Optimalna granična vrijednost za OSV je bila >0,593, a za OS >112 cm za KBB. AUC za perifernu neuropatiju je bio značajan samo za OSB i optimalna granična vrijednost za OSB je bila >1,409, uz nisku osjetljivost i visoku specifičnost. Rezultati našega istraživanja ukazuju na to da OSV, OS i OSB mogu biti jednostavna i neinvazivna metoda procjene učestalosti KBB i periferne neuropatije u pretilih bolesnika sa ŠB2

Clinical Usefulness of Anthropometric Indices to Predict the Presence of Prediabetes. Data from the ILERVAS Cohort

Prediabetes is closely related to excess body weight and adipose distribution. For this reason, we aimed to assess and compare the diagnostic usefulness of ten anthropometric adiposity indices to predict prediabetes. Cross-sectional study with 8188 overweight subjects free of type 2 diabetes from the ILERVAS project (NCT03228459). Prediabetes was diagnosed by levels of glycated hemoglobin (HbA1c). Total body adiposity indices [BMI, Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) and Deurenberg's formula] and abdominal adiposity (waist and neck circumferences, conicity index, waist to height ratio, Bonora's equation, A body shape index, and body roundness index) were calculated. The area under the receiver-operating characteristic (ROC) curve, the best cutoff and the prevalence of prediabetes around this value were calculated for every anthropometric index. All anthropometric indices other than the A body adiposity were higher in men and women with prediabetes compared with controls (p < 0.001 for all). In addition, a slightly positive correlation was found between indices and HbA1c in both sexes (r ≤ 0.182 and p ≤ 0.026 for all). None of the measures achieved acceptable levels of discrimination in ROC analysis (area under the ROC ≤ 0.63 for all). Assessing BMI, the prevalence of prediabetes among men increased from 20.4% to 36.2% around the cutoff of 28.2 kg/m2, with similar data among women (from 29.3 to 44.8% with a cutoff of 28.6 kg/m2). No lonely obesity index appears to be the perfect biomarker to use in clinical practice to detect individuals with prediabetes.This work was supported by grants from the Diputació de Lleida and Generalitat de Catalunya (2017SGR696 and SLT0021600250). CIBER de Diabetes y Enfermedades Metabólicas Asociadas and CIBER de Enfermedades Respiratorias are initiatives of the Instituto de Salud Carlos III

Obesity- and Lipid-Related Parameters in the Identification of Older Adults with a High Risk of Prediabetes According to the American Diabetes Association: An Analysis of the 2015 Health, Well-Being, and Aging Study

This study evaluated the predictive ability of 11 obesity- and lipid-related parameters, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), body roundness index (BRI), “A” body-shape index (ABSI), conicity index (C), visceral adiposity index (VAI), triglyceride-to-glucose fasting index (TyG), triglyceride-to-glucose fasting related to BMI (TyG-BMI), triglyceride-to-glucose fasting related to WC (TyG-WC), and triglyceride-to-glucose fasting related to WtHR (TyG-WtHR), to identify patients from an elderly Colombian population with a high risk of prediabetes according to the 2016 American Diabetes Association criteria. The data were obtained from the 2015 Colombian Health and Wellbeing and Aging Survey. A total of 3307 elderly Colombian individuals (aged over 60 years) were included. Anthropometric data, fasting plasma glucose, blood lipid profiles, family history, and health-related behaviors were assessed, and prediabetes was defined as a fasting plasma glucose of 100 to 125 mg/dL. The areas under the receiver operating characteristic (ROC) curves (AUCs) were calculated for each anthropometric indicator, using the prediabetes classification to identify their sensitivity and specificity, and these indicated that the prevalence of prediabetes was 25.3% in this population. After adjusting for potential confounding factors, the TyG index was strongly associated with the odds of having prediabetes in both sexes, and multivariate logistic regression analysis showed that the ORs for prediabetes increased across quartiles (p < 0.001).This study is part of a larger project that has been funded by a Colciencias y Ministerio de Salud y la Protección Social de Colombia (The SABE Study ID 2013, no. 764). Mikel Izquierdo is funded in part by a research grant PI17/01814 of the Ministerio de Economía, Industria y Competitividad (ISCIII, FEDER)

Validation of surrogate anthropometric indices in older adults: what is the best indicator of high cardiometabolic risk factor clustering?

Incluye correccionesThe present study evaluated the ability of five obesity-related parameters, including a body shape index (ABSI), conicity index (CI), body roundness index (BRI), body mass index (BMI), and waist-to-height ratio (WtHR) for predicting increased cardiometabolic risk in a population of elderly Colombians. A cross-sectional study was conducted on 1502 participants (60.3% women, mean age 70 ± 7.6 years) and subjects’ weight, height, waist circumference, serum lipid indices, blood pressure, and fasting plasma glucose were measured. A cardiometabolic risk index (CMRI) was calculated using the participants’ systolic and diastolic blood pressure, triglycerides, high-density lipoprotein and fasting glucose levels, and waist circumference. Following the International Diabetes Federation definition, metabolic syndrome was defined as having three or more metabolic abnormalities. All surrogate anthropometric indices correlated significantly with CMRI (p < 0.01). Receiver operating characteristic curve analysis of how well the anthropometric indices identified high cardiometabolic risk showed that WtHR and BRI were the most accurate indices. The best WtHR and BRI cut-off points in men were 0.56 (area under curve, AUC 0.77) and 4.71 (AUC 0.77), respectively. For women, the WtHR and BRI cut-off points were 0.63 (AUC 0.77) and 6.20 (AUC 0.77), respectively. In conclusion, BRI and WtHR have a moderate discriminating power for detecting high cardiometabolic risk in older Colombian adults, supporting the idea that both anthropometric indices are useful screening tools for use in the elderly

Anthropometric, metabolic and clinical factors associated with diabetes and prediabetes prevalence in women aged 65–74 living in central Poland

Background. Prevalence of type 2 diabetes mellitus is rising worldwide. Similar trend is also observed in Poland, especially in elderly population. The aim of this cross-sectional study was to assess prevalence and to identify anthropometric, metabolic and clinical factors associated with diabetes and prediabetes among women at early elderliness living in central Poland. Methods. 364 women aged 65–74 years, were included into the study. In all patients a history of diabetes and cardiovascular disease was obtained, blood pressure and anthropometric measurements were performed, blood samples for laboratory tests (fasting plasma glucose, lipid metabolism and creatinine) were drawn, ankle/brachial index was calculated, abdominal ultrasound with abdominal aorta diameter was performed and carotid intima/media thickness was measured. Data were collected during March and April 2012 in Gniewkowo, the rural-urban municipality in central Poland. Results. 98 women had diabetes (25 de novo) and 94 ones had prediabetes (81 de novo). Waist circumference, BMI, lipid abnormalities as well as anthropometric and metabolic indices: waist-to-height ratio (WHtR), triglycerides/HDL cholesterol ratio and visceral adiposity index (VAI) were significantly associated with abnormal glucose metabolism. Backward stepwise logistic regression analysis identified WHtR as the best single indicator of patients with diabetes, while again WHtR and VAI were the only independent indicators of any type of impaired glucose metabolism. Conclusions. Abnormal glucose metabolism is highly prevalent among women at early elderliness, especially in those with visceral obesity and abnormal lipid metabolism. Anthropometric and metabolic indices (WHtR and VAI) were better indicators of impaired glucose metabolism compared to separate measurements of single parameters.Background. Prevalence of type 2 diabetes mellitus is rising worldwide. Similar trend is also observed in Poland, especially in elderly population. The aim of this cross-sectional study was to assess prevalence and to identify anthropometric, metabolic and clinical factors associated with diabetes and prediabetes among women at early elderliness living in central Poland. Methods. 364 women aged 65–74 years, were included into the study. In all patients a history of diabetes and cardiovascular disease was obtained, blood pressure and anthropometric measurements were performed, blood samples for laboratory tests (fasting plasma glucose, lipid metabolism and creatinine) were drawn, ankle/brachial index was calculated, abdominal ultrasound with abdominal aorta diameter was performed and carotid intima/media thickness was measured. Data were collected during March and April 2012 in Gniewkowo, the rural-urban municipality in central Poland. Results. 98 women had diabetes (25 de novo) and 94 ones had prediabetes (81 de novo). Waist circumference, BMI, lipid abnormalities as well as anthropometric and metabolic indices: waist-to-height ratio (WHtR), triglycerides/HDL cholesterol ratio and visceral adiposity index (VAI) were significantly associated with abnormal glucose metabolism. Backward stepwise logistic regression analysis identified WHtR as the best single indicator of patients with diabetes, while again WHtR and VAI were the only independent indicators of any type of impaired glucose metabolism. Conclusions. Abnormal glucose metabolism is highly prevalent among women at early elderliness, especially in those with visceral obesity and abnormal lipid metabolism. Anthropometric and metabolic indices (WHtR and VAI) were better indicators of impaired glucose metabolism compared to separate measurements of single parameters

Utility of three anthropometric indices in assessing the cardiometabolic risk profile in children

Objectives: To evaluate the ability of BMI, WC and WHtR to identify increased cardiometabolic risk in pre-adolescents. Methods: This is a cross-sectional study involving 192 children (10.92 ± 0.58 years, 56% female) from the United Kingdom between 2010 and 2013. Receiver operating characteristic curves determined the discriminatory ability of BMI, WC and WHtR to identify individuals with increased cardiometabolic risk (increased clustered triglycerides, HDL-cholesterol, systolic blood pressure, cardiorespiratory fitness and glucose). Results: A WHtR ≥ 0.5 increased the odds by 5.2 (95% confidence interval 2.6, 10.3) of having increased cardiometabolic risk. Similar associations were observed for BMI and WC. Both BMI-z and WHtR were fair predictors of increased cardiometabolic risk although BMI-z demonstrated the best trade-off between sensitivity and specificity, 76.1% and 63.6%, compared to 68.1% and 65.5% for WHtR. Cross-validation analysis revealed that BMI-z and WHtR correctly classified 84% of individuals (kappa score = 0.671, 95% CI 0.55, 0.79). The sensitivity of the cut-points suggests that 89.3% of individuals were correctly classified as being at risk with only 10.7% misdiagnosed whereas the specificity of the cut-points indicated that 77.8% of individuals were correctly identified as being healthy with 22.2% of individuals incorrectly diagnosed as being at risk. Conclusions: Findings suggest that WHtR provides similar cardiometabolic risk estimates to age and sex adjusted BMI