Abdominal obesity and the prevalence of diabetes and intermediate hyperglycaemia in Chinese adults

Objective: To assess the association of indicators of general and abdominal obesity with the prevalence of type 2 diabetes (T2DM) and intermediate hyperglycaemia (IHG) in the Chinese population. Methods: We used data of 50 905 adults aged 18¿79 years in the 2002 China National Nutrition and Health Survey. Recommended Chinese cut-off values were used for BMI (24 kg/m2) and waist circumference (WC; 85 cm in men, 80 cm in women). Optimal cut-offs for waist:height ratio (WHtR) were determined from analyses of receiver-operating characteristic (ROC) curves. Results: The prevalence of T2DM and IHG was 2?6% and 1?9% respectively. ROC curve analyses indicated 0?5 as the optimal cut-off value for WHtR in both sexes. High BMI, WC and WHtR were all associated with the prevalence of glucose tolerance abnormalities, with the highest prevalence ratio (PR) for high WHtR (men: PR52?85, 95% CI 2?54, 3?21; women: PR53?10, 95% CI 2?74, 3?51). When combining BMI and WHtR, in men either a high BMI or a high WHtR alone was associated with increased risk. Among women, a high BMI without a concomitant high WHtR was not associated with increased glucose tolerance abnormalities risk, whereas a high WHtR was associated with risk irrespective of BMI. Conclusions: Among the Chinese adult population measures of central obesity are better predictors of glucose tolerance abnormalities prevalence than BMI. AWHtR cutoff point of 0?5 for both men and women can be considered as optimum for predicting (pre-) diabetes and may be a useful tool for screening and health education

Age and Body Anthropometry as Predicting Factors for Carpal Tunnel Syndrome among Egyptian Obese Women

BACKGROUND: Carpal tunnel syndrome (CTS) is the most prevalent entrapment neuropathy in the upper limb. The most consistent risk factors are female gender, age, and obesity. The results of previous studies are conflicting, and moreover, data from studies regarding obesity and nerve conduction velocity are not available for our Egyptian population. AIM: This study was designed to investigate the contribution of age and body anthropometry as predictor factors to the CTS and to identify patients at high risk for CTS among Egyptian obese women. METHODS: The study included 120 obese women grouped according to the clinical and electrodiagnostic (EDX) findings into two groups: 60 with CTS and 60 without CTS (non-CTS). EDX study was used in the diagnosis of median nerve entrapment at the level of the wrist, according to the American Association of Neuromuscular and EDX Medicine. Body weight and height were measured and then body mass index (BMI) was calculated. Waist-to-hip ratio (WHR) was determined from the measured waist circumference (WC) and hip circumference (HC). Mid upper arm circumference (MUAC) was measured as well. The receiver operating characteristic (ROC) curve was used to assess the power of age and body anthropometry as predictor factors for CTS. RESULTS: CTS obese cases showed significantly lower values of both median motor nerve conduction velocity (MMNCV) and median sensory nerve conduction velocity compared to those without CTS. Significantly higher median sensory latency and median motor latency have been found in CTS cases compared to non-CTS group. Significant differences in the mean age have been found between the two groups and a tendency for higher body anthropometry measures in the CTS cases relative to those without CTS. Moreover, there were negative correlations between MMNCV and obesity indices. Age showed the highest area under the ROC curve, followed by BMI, WHR WC, HC, and MUAC. CONCLUSION: Age and obesity indices are important risk factors that can be used as predictors to CTS in obese women. Age is a more powerful diagnostic tool relative to the anthropometric measurements. Women of age above 40 years and suffering from a high degree of obesity are at risk of developing CTS

Prevalence and association of obesity with self-reported comorbidity: a cross-sectional study of 1321 adult participants in Lasbela, Balochistan

Association of fatness with chronic metabolic diseases is a well-established fact, and a high prevalence of risk factors for these disorders has increasingly been reported in the third world. In order to incorporate any preventive strategies for such risk factors into clinical practice, decision-makers require objective evidence about the associated burden of disease. A cross-sectional study of 1321 adults from one of the districts of Balochistan, among the most economically challenged areas of Pakistan, was carried out for the measures of fatness and self-reported comorbidities. Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) were measured and demographic information and self-reported comorbidities were documented.The prevalence of obesity was 4.8% (95% CI: [3.8, 6.1]) and 21.7% (95% CI: [19.5, 24.0]), as defined by the World Health Organization (WHO) international and Asia/Asia-Pacific BMI cut-offs, respectively. The proportion exhibiting comorbidity increased with increasing levels of fatness in a dose-response relationship

The association between graded physical activity in postmenopausal British women, and the prevalence and incidence of hip and wrist fractures.

BACKGROUND: physical activity is promoted for older women as a means of maintaining health and avoiding falls and fractures. Findings relating physical activity of older women to risk of falls and fracture are contradictory. The association between level of physical activity and prevalent and incident hip and wrist fractures was examined in a large representative sample of postmenopausal British women. METHODS: data from the British Women's Heart and Health Study, a cohort study of 4286 postmenopausal women aged 60-79, from 23 UK towns were used. Information on physical activity, anthropometry, falls and hip and wrist fractures from baseline examination and questionnaire (1999-2001) and follow-up questionnaire (2007) were available. Cross-sectional baseline prevalence data were analysed using logistic regression and cohort incidence data using a Cox proportional hazards model examining the association of physical activity with fracture outcomes. RESULTS: 3003 (70%) women, with complete baseline data, were studied. 13.6% had previously fractured a wrist and 1.3% a hip. Analyses unadjusted for confounders showed moderate protective associations between activity and fracture risk. After adjustment for confounders there was a weak trend towards fewer hip fractures (adjusted OR 0.13 [0.01, 1.18]) and more wrist fractures (adjusted OR 1.35 [0.76, 2.48]), amongst most active compared with inactive women. The crude incidence rate of wrist and/or hip fracture was 7.0 [5.9, 8.2] per 1000 person-years. No evidence was found for an association between physical activity and combined incident hip and/or wrist fracture (adjusted rate ratio inactive versus most active 1.69 [0.67, 4.24]). CONCLUSION: no clear associations between graded physical activity and hip/wrist fractures were seen but estimates were imprecise. Physical activities are heterogeneous and individual fracture types and mechanisms differ. Very large prospective observational studies are required to disentangle the precise effects of different activity patterns on different fracture types

Evaluation of Anthropometric Parameters of Central Obesity among Professional Drivers: A Receiver Operating Characteristic Analysis

Different anthropometric parameters have been proposed for assessing central obesity. The diagnostic performance of these anthropometric parameters and their ability to correctly measure central obesity for the professional community, like drivers, is questionable and needs to be assessed. The study aimed to examine the diagnostic performance of anthropometric parameters as indicators of central obesity in drivers as measured by waist circumference (WC) and to determine the best cut-off values for these parameters that would identify obese drivers. Anthropometric measurements from a cross-sectional sample of 197 professional drivers were taken under standard protocol. Receiver operating characteristics (ROC) analysis was used to examine the diagnostic performance and to determine the optimal cut-off point of each anthropometric parameter to identify centrally obese drivers. It was found that WC had a significant positive correlation with all other obesity indicators. The ROC curve analysis indicated that all the parameters analyzed had a good performance, but the waist-to-height ratio (WHtR) had a more predictive value of the area under the curve (AUC). Optimal cut-offs to identify central obesity in drivers were 0.55, 2.06, 0.95, and 25.44 for WHtR, conicity index, waist-to-hip ratio, and body mass index, respectively. These cut-off points for different indicators can be used to detect central obesity for drivers.

Anthropometric discriminators of type 2 diabetes among White and Black American adults

BACKGROUND: The aim of the present study was to determine the best anthropometric discriminators of type 2 diabetes mellitus (T2DM) among White and Black males and females in a large US sample. METHODS: We used Atherosclerosis Risk in Communities study baseline data (1987–89) from 15 242 participants (1827 with T2DM) aged 45–65 years. Anthropometric measures included a body shape index (ABSI), body adiposity index (BAI), body mass index, waist circumference (WC), waist:height ratio (WHtR), and waist:hip ratio (WHR). All anthropometric measures were standardized to Z-scores. Using logistic regression, odds ratios for T2DM were adjusted for age, physical activity, and family history of T2DM. The Akaike information criterion and receiver operating characteristic C-statistic were used to select the best-fit models. RESULTS: Body mass index, WC, WHtR, and WHR were comparable discriminators of T2DM among White and Black males, and were superior to ABSI and BAI in predicting T2DM (P < 0.0001). Waist circumference, WHtR, and WHR were the best discriminators among White females, whereas WHR was the best discriminator among Black females. The ABSI was the poorest discriminator of T2DM for all race–gender groups except Black females. Anthropometric values distinguishing T2DM cases from non-cases were lower for Black than White adults. CONCLUSIONS: Anthropometric measures that included WC, either alone or relative to height (WHtR) or hip circumference (WHR), were the strongest discriminators of T2DM across race–gender groups. Body mass index was a comparable discriminator to WC, WHtR, and WHR among males, but not females

Waist-to-Height Ratio and Cardiovascular Risk Factors in Elderly Individuals at High Cardiovascular Risk

IntroductionSeveral anthropometric measurements have been associated with cardiovascular disease, type-2 diabetes mellitus and other cardiovascular risk conditions, such as hypertension or metabolic syndrome. Waist-to-height-ratio has been proposed as a useful tool for assessing abdominal obesity, correcting other measurements for the height of the individual. We compared the ability of several anthropometric measurements to predict the presence of type-2 diabetes, hyperglycemia, hypertension, atherogenic dyslipidemia or metabolic syndrome.Materials and MethodsIn our cross-sectional analyses we included 7447 Spanish individuals at high cardiovascular risk, men aged 55–80 years and women aged 60–80 years, from the PREDIMED study. Logistic regression models were fitted to evaluate the odds ratio of presenting each cardiovascular risk factor according to various anthropometric measures. The areas under the receiver-operating characteristic curve (AUC) were used to compare the predictive ability of these measurements.ResultsIn this relatively homogeneous cohort with 48.6% of type-2 diabetic individuals, the great majority of the studied anthropometric parameters were significantly and positively associated with the cardiovascular risk factors. No association was found between BMI and body weight and diabetes mellitus. The AUCs for the waist-to-height ratio and waist circumference were significantly higher than the AUCs for BMI or weight for type-2 diabetes, hyperglycemia, atherogenic dyslipidemia and metabolic syndrome. Conversely, BMI was the strongest predictor of hypertension.ConclusionsWe concluded that measures of abdominal obesity showed higher discriminative ability for diabetes mellitus, high fasting plasma glucose, atherogenic dyslipidemia and metabolic syndrome than BMI or weight in a large cohort of elderly Mediterranean individuals at high cardiovascular risk. No significant differences were found between the predictive abilities of waist-to-height ratio and waist circumference on the metabolic disease

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

Association between noninvasive fibrosis markers and cardio-vascular organ damage among adults with hepatic steatosis

Evidence suggests that advanced fibrosis, as determined by the noninvasive NAFLD fibrosis score (NFS), is a predictor of cardiovascular mortality in individuals with ultrasonography-diagnosed NAFLD. Whether the severity of histology (i.e., fibrosis stage) is associated with more pronounced cardiovascular organ damage is unsettled. In this study, we analyzed the clinical utility of NFS in assessing increased carotid intima-media thickness (cIMT), and left ventricular mass index (LVMI). In this cross-sectional study NFS, cIMT and LVMI were assessed in 400 individuals with ultrasonography-diagnosed steatosis. As compared with individuals at low probability of liver fibrosis, individuals both at high and at intermediate probability of fibrosis showed an unfavorable cardio-metabolic risk profile having significantly higher values of waist circumference, insulin resistance, high sensitivity C-reactive protein (hsCRP), fibrinogen, cIMT, and LVMI, and lower insulin-like growth factor-1 (IGF-1) levels. The differences in cIMT and LVMI remained significant after adjustment for smoking and metabolic syndrome. In a logistic regression model adjusted for age, gender, smoking, and diagnosis of metabolic syndrome, individuals at high probability of fibrosis had a 3.9-fold increased risk of vascular atherosclerosis, defined as cIMT.0.9 mm, (OR 3.95, 95% CI 1.12–13.87) as compared with individuals at low probability of fibrosis. Individuals at high probability of fibrosis had a 3.5-fold increased risk of left ventricular hypertrophy (LVH) (OR 3.55, 95% CI 1.22–10.34) as compared with individuals at low probability of fibrosis. In conclusion, advanced fibrosis, determined by noninvasive fibrosis markers, is associated with cardiovascular organ damage independent of other known factors