Waist-to-height ratio is independently related to whole and central body fat, regardless of the waist circumference measurement protocol, in non-alcoholic fatty liver disease patients

This is the peer reviewed version of the following article: Pimenta N.M., Cortez-Pinto H., Melo X., Silva-Nunes J., Sardinha L.B. & Santa-Clara H. (2017) Waist-to-height ratio is independently related to whole and central body fat, regardless of the waist circumference measurement protocol, in non-alcoholic fatty liver disease patients. J Hum Nutr Diet. 30, 185–192, which has been published in final form atdoi: 10.1111/jhn.12410. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Background: Waist-to-height ratio (WHtR) has been reported as a prefer-able risk related body fat (BF) marker, although no standardised waistcircumference measurement protocol (WCmp) has been proposed. Thepresent study aimed to investigate whether the use of a different WCmpaffects the strength of relationship between WHtR and both whole andcentral BF in non-alcoholic fatty liver disease (NAFLD) patients.Methods: BF was assessed with dual energy X-ray absorptiometry (DXA) in28 NAFLD patients [19 males, mean (SD) 51 (13) years and nine females,47 (13) years]. All subjects also underwent anthropometric evaluationincluding height and waist circumference (WC) measurement using fourdifferent WCmp (WC1, minimal waist; WC2, iliac crest; WC3, mid-distancebetween iliac crest and lowest rib; WC4, at the umbilicus) and WHtR wascalculated using each WC measurements (WHtR1, WHtR2, WHtR3 andWHtR4, respectively). Partial correlations were conducted to assess the rela-tion of WHtR and DXA assessed BF.Results: All WHtR were particularly correlated with central BF, includingabdominal BF (r = 0.80, r = 0.84, r = 0.84 and r = 0.78, respectively, forWHtR1, WHtR2, WHtR3 and WHtR4) and central abdominal BF (r = 0.72,r = 0.77, r = 0.76 and r = 0.71, respectively, for WHtR1, WHtR2, WHtR3and WHtR4), after controlling for age, sex and body mass index. There wereno differences between the correlation coefficients obtained between allstudied WHtR and each whole and central BF variable.Conclusions: Waist-to-height ratio was found a suitable BF marker in thepresent sample of NAFLD patients and the strength of the relationshipbetween WHtR and both whole and central BF was not altered by usingdifferent WCmp in the present sample of NAFLD patients.FUNDING SOURCES The first author of this paper was supported by a research grant (PhD scholarship) from the Foundation for Science and Technology (FCT), Ministry of Education and Science of Portugal (grant: SFRH/ BD/ 70515/ 2010). The present study was funded by: the Centre for the Study of Human Performance, Portuguese Foundation for Science and Technology, Lisbon, Portugal.info:eu-repo/semantics/publishedVersio

Waist circumference in Liver Disease

Background Central fat accumulation is important in Non-alcoholic Fatty Liver Disease (NAFLD) etiology. It is unknown weather any commonly used waist circumference (WC) measurement protocol (mp), as whole and central fat accumulation marker, is preferable for patients with NAFLD. The present study sought to find a preferable WC mp to be used in patients with NAFLD, based on three-fold criterion. Material and methods Body fat (BF) was assessed through Dual Energy X-ray Absorptiometry (DXA) in 28 patients with NAFLD (19 males, 51 + 13 yrs, and 9 females, 47 + 13 yrs). WC was measured using four different WC mp (WC1-narrowest torso, WC2- just above iliac crest, WC3- mid-distance between iliac crest and last rib and WC4- at the umbilicus). Results All WC measurements were highly correlated particularly with central BF depots, including trunk BF (r=0.78; r=0.82; r=0.82; r=0.84; respectively for WC1, WC2, WC3 and WC4) abdominal BF (r=0.78; r=0.78; r=0.80; r=0.72; respectively for WC1, WC2, WC3 and WC4) and central abdominal BF (r=0.76; r=0.77; r=0.78; r=0.68; respectively for WC1, WC2, WC3 and WC4), controlling for age, sex and body mass index. There were no differences between the correlation coefficients obtained between all studied WC measurements and each whole and central analyzed BF variable. Conclusion All studied WC mp seem suitable for use in patients with NAFLD, particularly as central BF clinical assessment tool, though not interchangeably. Hence biological and precision criteria alone did not sanction the superiority of any WC mp. Practical criteria may endorse WC measured at the iliac crest.info:eu-repo/semantics/publishedVersio

Waist-to-Hip Ratio is Related to Body Fat Content and Distribution Regardless of the Waist Circumference Measurement Protocol, in Non-Alcoholic Fatty Liver Disease Patients

Central accumulation and distribution of body fat (BF) is an important cardiometabolic risk factor. Waist-to-hip ratio (WHR), commonly elevated in non-alcoholic fatty liver disease (NAFLD) patients, has been endorsed as a risk related marker of central BF content and distribution, but no standardized waist circumference measurement protocol (WCmp) has been proposed. We aimed to investigate whether using different WCmp affects the strength of association between WHR and BF content and distribution in NAFLD patients. BF was assessed with Dual Energy X-ray Absorptiometry (DXA) in 28 NAFLD patients (19 males, 51 ± 13 yrs, and 9 females, 47 ± 13 yrs). Waist circumference (WC) was measured using four different WCmp (WC1: minimal waist; WC2: iliac crest; WC3: mid-distance between iliac crest and lowest rib; WC4: at the umbilicus) and WHR was calculated accordingly (WHR1, WHR2, WHR3 and WHR4, respectively). High WHR was found in up to 84.6% of subjects, depending on the WHR considered. With the exception of WHR1, all WHR correlated well with abdominal BF (r=0.47 for WHR1; r=0.59 for WHR2 and WHR3; r=0.58 for WHR4) and BF distribution (r=0.45 for WHR1; r=0.56 for WHR2 and WHR3; r=0.51 for WHR4), controlling for age, sex and body mass index (BMI). WHR2 and WHR3 diagnosed exactly the same prevalence of high WHR (76.9%). The present study confirms the strong relation between WHR and central BF, regardless of WCmp used, in NAFLD patients. WHR2 and WHR3 seemed preferable for use in clinical practice, interchangeably, for the diagnosis of high WHR in NAFLD patients.co-financed by national funds through the Programa Operacional do Alentejo (ALENT-07-0262-FEDER-001883)info:eu-repo/semantics/publishedVersio

Correlation between functional capacity and health-related quality of life in Chronic Obstructive Pulmonary Disease patient

Poster presented at the 3rd International Congress of CiiEM - "Research and Innovation in Human and Health Sciences. 20-22 June 2018, Campus Egas Moniz, Monte de Caparica, PortugalN/

Functional capacity and health status in patient with Chronic Obstructive Pulmonary Disease

Poster presented at the 4th International Congress of CiiEM - "Health, Well-being and Ageing in the XXI Century." 2-5 June 2019, Campus Egas Moniz, Caparica, PortugalN/

Functional capacity and health status in patient with chronic obstructive pulmonary disease

Abstract in proceedings of the Fourth International Congress of CiiEM: Health, Well-Being and Ageing in the 21st Century, held at Egas Moniz’ University Campus in Monte de Caparica, Almada, from 3–5 June 2019.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/publishedVersio

The acute effect of maximal exercise on central and peripheral arterial stiffness indices and hemodynamics in children and adults

Xavier Melo is supported by a research grant from the Foundation for Science and Technology (FCT), Ministry of Education and Science of Portugal (grant: SFRH/ BD/ 70515/ 2010). Nuno M. Pimenta is cofinanced by national funds through the Programa Operacional do Alentejo 2007-2013 (ALENT-07-0262- FEDER-001883)This study compared the effects of a bout of maximal running exercise on arterial stiffness in children and adults. Right carotid blood pressure and artery stiffness indices measured by pulse wave velocity (PWV), compliance and distensibility coefficients, stiffness index α and β (echo-tracking), contralateral carotid blood pressure, and upper and lower limb and central/aortic PWV (applanation tonometry) were taken at rest and 10 min after a bout of maximal treadmill running in 34 children (7.38 ± 0.38 years) and 45 young adults (25.22 ± 0.91 years) having similar aerobic potential. Two-by-two repeated measures analysis of variance and analysis of covariance were used to detect differences with exercise between groups. Carotid pulse pressure (PP; η(2) = 0.394) increased more in adults after exercise (p < 0.05). Compliance (η(2) = 0.385) decreased in particular in adults and in those with high changes in distending pressure, similarly to stiffness index α and β. Carotid PWV increased more in adults and was related to local changes in PP but not mean arterial pressure (MAP). Stiffness in the lower limbs decreased (η(2) = 0.115) but apparently only in those with small MAP changes (η(2) = 0.111). No significant exercise or group interaction effects were found when variables were adjusted to height. An acute bout of maximal exercise can alter arterial stiffness and hemodynamics in the carotid artery and within the active muscle beds. Arterial stiffness and hemodynamic response to metabolic demands during exercise in children simply reflect their smaller body size and may not indicate a particular physiological difference compared with adults.info:eu-repo/semantics/publishedVersio

Linking cardiorespiratory fitness classification criteria to early subclinical atherosclerosis in children

It is unclear if cardiorespiratory fitness (CRF) can be used as a screening tool for premature changes in carotid intima-media thickness (cIMT) in paediatric populations. The purpose of this cross-sectional study was 3-fold: (i) to determine if CRF can be used to screen increased cIMT; (ii) to determine an optimal CRF cut-off to predict increased cIMT; and (iii) to evaluate its ability to predict increased cIMT among children in comparison with existent CRF cut-offs. cIMT was assessed with high-resolution ultrasonography and CRF was determined using a maximal cycle test. Receiver operating characteristic analyses were conducted in boys (n = 211) and girls (n = 202) aged 11-12 years to define the optimal sex-specific CRF cut-off to classify increased cIMT (≥75th percentile). Logistic regression was used to examine the association between the CRF cut-offs with the risk of having an increased cIMT. The optimal CRF cut-offs to predict increased cIMT were 45.81 and 34.46 mL·kg(-1)·min(-1) for boys and girls, respectively. The odds-ratios for having increased cIMT among children who were unfit was up to 2.8 times the odds among those who were fit (95% confidence interval: 1.40-5.53). Considering current CRF cut-offs, only those suggested by Adegboye et al. 2011. (Br. J. Sports Med. 45(9): 722-728) and Boddy et al. 2012 (PLoS One, 7(9): e45755) were significant in predicting increased cIMT. In conclusion, CRF cut-offs (boys: ≤ 45.8; girls: ≤ 34.5 mL·kg(-1)·min(-1)) are associated with thickening of the arterial wall in 11- to 12-year-old children. Low CRF is an important cardiovascular risk factor in children and our data highlight the importance of obtaining an adequate CRF.info:eu-repo/semantics/publishedVersio

Análise comparativa da composição corporal e da distribuição de gordura corporal de sujeitos com doença das artérias coronárias envolvidos num programa de reabilitação cardíaca versus sedentários

O objectivo desta investigação foi analisar a composição corporal e a distribuição de gordura corporal de sujeitos com doença das artérias coronárias (DAC) envolvidos num programa estruturado de reabilitação cardíaca (PRC) e sujeitos com DAC que não participam em qualquer PRC. População e métodos: A amostra foi constituída por 62 sujeitos do sexo masculino, caucasianos, com DAC diagnosticada, oriundos de cada um de dois grupos estudados: grupo C/PRC (n=31) foi constituído por sujeitos que participavam na fase IV de um PRC há mais de um ano (idade: 58 + 10 anos); grupo S/PRC (n=31) foi constituído por sujeitos que não participavam em qualquer PRC (idade: 59 + 12 anos). Foi observada a composição corporal e distribuição de gordura corporal dos sujeitos da amostra, através da análise por Densitometria por Raio-X de Dupla Energia (DXA). Foram recolhidas medidas antropométricas.The aim of this investigation was to analyze differences in body composition and body fat distribution between subjects following a structured cardiac rehabilitation program (CRP) and subjects not involved in any CRP. Methods: Body composition and body fat distribution were assessed by dual-energy X-ray absorptiometry (DXA) in 62 male subjects, white, who had been diagnosed with coronary artery disease (CAD). The sample came from two groups: a CRP group (n=31) who had been engaged in phase IV of a CRP for more than a year (age: 58±10 years), and a nonCRP group (n=31) who were not involved in any CRP (age: 59±12 years.info:eu-repo/semantics/publishedVersio

Effects of an exercise training program in physical condition after liver transplantation in familial amyloidotic polyneuropathy: a case report

Introduction: Familial amyloidotic polyneuropathy (FAP) is a neurodegenerative disease that leads to sensory and motor polyneuropathies as well as functional limitations. So far, liver transplantation is the only treatment for FAP because the mutated protein causing the disease is mainly produced in the liver. With the increasing survival of transplant recipients, functional and cardiovascular problems as consequences of immunosuppressant side effects are increasing associated with sedentary lifestyles and/or retransplantation status. We sought to analyze the impact of exercise training programs on 1 FAP patient’s course long-term after liver transplantation. Methodology. A FAP patient (female; 49 years of age; body mass index 18.8 kg/m2) underwent a liver transplantation 133 months before assessment. She was assessed for body composition, isometric quadriceps muscle strength, functional capacity, fatigue, and levels of physical activity before and after a 6-month period of combined exercise training. Results: After the exercise training program, almost all variables were improved, namely, total body skeletal muscle mass, proximal femoral bone mineral density, quadriceps strength, maximal oxygen consumption on 6 minutes walk test (6mwt) or VO2peak, total ventilation on 6mwt, and fatigue. The improvement in distance on 6mwt (69.2 m) was clinically significant. Preintervention the levels of physical activity were below international recommendations for health; after the program they achieved the recommendations. Conclusion: The results showed an improvement in functional capacity with a decrease in future disability risk associated with a better lifestyle with respect to physical activity levels in 1 patient