Waist‐to‐hip ratio and mortality in heart failure

Aims

A higher body mass index (BMI) is associated with better survival in heart failure (HF) patients, also known as the obesity paradox. However, BMI does not account for body composition. We therefore analysed the association between abdominal fat, measured via waist‐to‐hip ratio (WHR), BMI and all‐cause mortality in patients with HF.

Methods and results

For this analysis, 1738 patients from the Scottish BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT‐CHF) validation study were included. Patients without waist and hip measurements were excluded. WHR was defined as waist circumference/hip circumference, divided into tertiles and split for sex. A linear regression of principal components from an extensive panel of biomarkers was performed to provide insight in the pathophysiology behind a higher WHR. In total, 1479 patients were included, of which 33% were female and mean age was 75 ±11 years. A higher WHR was independently associated with a higher BMI, a higher prevalence of diabetes and higher New York Heart Association functional class. There was a significant interaction between sex and WHR on its association with mortality (P <0.001). In women, a higher WHR was associated with a higher mortality risk [hazard ratio (HR) 2.23, 95% confidence interval (CI) 1.37–3.63; P =0.001], whereas no significant association was found in men (HR 0.87, 95% CI 0.63–1.20; P = 0.409). We found a strong association between a higher WHR and elevated markers of inflammation and MAPK cascade in women, while these associations were less profound in men.

Conclusions

A higher WHR was associated with a higher risk of death in female but not in male HF patients. These findings challenge the obesity paradox, and suggest that fat deposition is pathophysiologically harmful and may be a target for therapy in female patients with HF.     

Birth weight and its association with blood pressure and nutritional status in adolescents

Objective

The management of children with low birth weight is not the same in countries with different resources. The authors assessed the association of birth weight with blood pressure and nutritional status in a representative sample of adolescents from a Brazilian state, aiming to identify possible consequences of these differences.

成人腰围、体重指数与高三酰甘油血症的关系

目的探讨体重指数（BMI）、腰围（WC）与三酰甘油水平之间的关系,并用受试者工作特征（ROC）凹线评价BMI和WC对诊断高三酰甘油血症的价值。方法以2008年7至9月在我院进行常规体检的1093人（男性707人、女性386人）为研究对象,检测身高、体重、腰围和血三酰甘油水平。比较三酰甘油正常组与异常组BMI和WC的差异。建立BMI和WC的ROC曲线,获得曲线下面积及曲线上各界值点的灵敏度和特异度。结果男女性三酰甘油异常率分别为33．5％和8．3％。三酰甘油异常者的BMI和WC明显大于三酰甘油正常者（P〈0．01）。以BMI诊断高三酰甘油血症的ROC曲线下面积：男性为0．728±0．041、女性为0．708±0．021,最佳界值点：男性为24．5、女性为22．5;以WC诊断高三酰甘油血症的ROC曲线下面积：男性为0．790±0．042,女性为0．714±0．020,最佳界值点：男性为86cm,女性为77cm。结论BMI和WC与三酰甘油水平均相关。BMI和WC是预测高三酰甘油血症较为理想的指标。     

Cut-off of body mass index and waist circumference to predict hypertension in Indian adults

AIM: To determine the cut-off values of body mass index(BMI) and waist circumference to predict hypertension in adults in north India.METHODS: A community based cross-sectional study was conducted in 801 subjects in Kanpur, aged 20 years and above, using multistage stratified random sampling technique. A pre-tested structured question-naire was used to elicit the required information from the study participants and the diagnostic criteria for hypertension were taken according to the Seventh Joint National Committee Report on Hypertension(JNC-7). Receiver operating characteristic(ROC) analysis was used to estimate the cut-off values of BMI and waist circumference to predict hypertension.RESULTS: The ROC analysis revealed that BMI is a good predictor of hypertension for both men(area under the ROC curve 0.714) and women(area under the ROC curve 0.821). The cut-off values of BMI for predicting hypertension were identified as ≥ 24.5 kg/m2 in men and ≥ 24.9 kg/m2 in women. Similarly, the ROC analysis for waist circumference showed that it is a good predictor of hypertension both for men(area under the ROC curve 0.784) and women(area under the ROC curve 0.815). The cut-offs for waist circumference for predicting hypertension were estimated as ≥ 83 cm for men and ≥ 78 cm for women. Adults with high BMI or high waist circumference had a higher prevalence of hypertension, respectively.CONCLUSION: Simple anthropometric measurements such as BMI and waist circumference can be used for screening people at increased risk of hypertension in order to refer them for more careful and early diagnostic evaluation. Policies and programs are required for primary and secondary prevention of hypertension.     

济南市健康体检女性膳食模式与测量指标的相关性

目的 探讨济南市体检女性膳食模式与体质量指数(BMI)和腰围的关系。方法 对2010年12月至2011年4月在济南市某医院健康体检中心体检的595名女性进行了膳食调查和身高、体质量、腰围、臀围等测量。采用因子分析方法,选出特征根>1.0的因子,得出主要膳食模式;用多元回归分析各膳食模式与BMI、腰围以及腰臀比的相关性。结果 调查对象BMI、腰围及腰臀比异常检出率分别为32.4%、36.64%和30.42%,均随年龄增加呈增加趋势。因子分析得到6种膳食模式较有意义,分别为传统模式、高油盐模式、水果奶类模式、素食模式、零食模式和酒类模式。经多元回归分析,调整年龄后,高油盐模式与BMI和腰围呈正相关。结论 济南市健康体检女性的膳食模式呈多样性,膳食模式与BMI和腰围关系密切,高油盐模式易引起BMI和腰围增加。     

体质量指数及腰围不影响胃癌病人的短期手术结局

目的:探讨肥胖及腹型肥胖对于胃癌病人短期手术结局的影响。方法:回顾性收集经腹胃切除+D2淋巴结清扫术的226例胃癌病人临床资料。手术前分别测量身高、体重和腰围,根据体质量指数(BMI),将病人分为非肥胖组、超重组和肥胖组;根据腰围,将病人分为非腹型肥胖组、腹型肥胖组。比较各组病人术中出血量、手术时间、术后住院天数、术后胃周淋巴结检出数及术后并发症。结果:非肥胖组、超重组、肥胖组3组间的平均手术时间(P=0.451)、平均术中出血量(P=0.949)、平均术后住院天数(P=0.745)、平均总淋巴结检出数(P=0.165)无统计学差异。非腹型肥胖组与腹型肥胖组间的手术时间(P=0.886)、平均术中出血量(P=0.596),平均术后住院天数(P=0.555)、平均总淋巴结检出数(P=0.209)亦无统计学差异。术后27例发生早期并发症,发生率为12.3%,其在BMI非肥胖组、超重组、肥胖组(P=0.394)间及非腹型肥胖组、腹型肥胖组(P=0.846)间均无统计学差异。结论:BMI及腰围不影响胃癌病人的手术时间、出血量、住院天数、淋巴结检出数及早期术后并发症。     

聚焦光束在生物组织中传输的数值模拟

目的 模拟光子在生物组织类物质中的传输过程,分析漫反射光能分布和组织内部目标区域内光能分布特性。方法 采用蒙特卡洛数值模拟方法,在生物组织内设定目标区域,将光子分为一类和二类光子进行研究。模拟高斯聚焦光束入射并记录目标区域的光能密度分布以及漫反射光子的能量状态和平均散射次数。结果 在目标区域,被散射的一类光子数目随聚焦深度的增加衰减迅速。目标区域外被散射的二类光子的能量分布和平均散射次数基本恒定,与聚焦位置无关。在组织内部聚焦位置的能量密度分布与束腰半径和聚焦深度相关。结论 在散射作用下,一类光子和二类光子随聚焦深度具有不同的衰减特性。聚焦于目标区域的光能密度分布存在扩散现象,高斯光束的束腰越小的光束产生的扩散现象越严重,透射深度越浅。数值计算结果可为生物医学光学成像和光动力医疗研究提供参考。     

腰围甘油三酯指数与胸痛患者代谢综合征相关性的研究

目的 研究胸痛患者腰围甘油三酯（WT）指数与代谢综合征（MS）的关系。 方法 回顾性分析在我院就诊的胸痛患者。比较MS组和非MS组基线资料的差异，分析WT指数与代谢综合征组的相关性。 结果 共有309例患者入选，其中女性115例。MS的检出率为71.1%。MS组的体重、腰围、低密度脂蛋白胆固醇、甘油三酯、空腹血糖、体重指数和腰WT指数均高于非MS组（P<0.05）；高密度脂蛋白胆固醇低于非聚集组（P<0.05）。多因素Logistic回归表明，WT指数是代谢综合征的独立预测因素（OR=1.075，95%CI：1.028~1.124）。WT指数在全部研究人群、男性人群及女性人群， ROC曲线下面积分别为0.839（95%CI：0.793~0.878）、0.877（95%CI：0.803~0.931）和0.858（95%CI：0.801~0.904）；其预测心血管危险因素聚集的最佳切点分别为143.0、142.0和139.1。 结论 WT指数是胸痛患者代谢综合征的独立预测因素, 适合于基层医疗机构对高危心血管病人群进行筛查。     

射频辅助腰腹部吸脂联合下腹壁整形术的临床效果

目的 探究射频辅助腰腹部吸脂联合下腹壁整形术的临床效果。方法 选取2021年3月-2023年3月 于我院行吸脂手术的80例患者为研究对象，采用随机数字表法分为常规组和研究组，每组40例。常规组采 用传统吸脂术，研究组采用射频辅助腰腹部吸脂联合下腹壁整形术，比较两组手术抽吸量、手术时间、腰 围周径减少量、消肿时间及满意度。结果 研究组手术抽吸量、腰围周径减少量均大于常规组，消肿时间短 于常规组（P＜0.05）；两组手术时间比较，差异无统计学意义（P＞0.05）；研究组满意率及满意度评分 均高于常规组（P＜0.05）。结论 射频辅助腰腹部吸脂联合下腹壁整形术的整体效果较好，可提高手术抽 吸量，缩小腰围周径，且术后消肿时间较短，恢复较快，患者满意度较高。