Waist circumference, dual-energy X-ray absortiometrically measured abdominal adiposity, and computed tomographically derived intra-abdominal fat area on detecting metabolic risk factors in obese women

OBJECTIVES: We investigated which abdominal adiposity measurements, waist circumference (WC), dual-energy X-ray absorptiometry (DXA)-measured abdominal fat, and computed tomography (CT)-derived intra-abdominal fat areas (IAF), were the most predictive in identifying metabolic risk factors. METHODS: Ninety-five Korean women (body mass index 27.5 +/- 3.2 kg/m(2), WC 90.2 +/- 6.8 cm, age 42 +/- 10.6 y) with abdominal obesity (WC > or = 80 cm) were examined in this study. Abdominal adiposity was assessed using DXA (absolute values and percentages of trunk and android fat, trunk-to-leg fat ratio, and android-to-gynoid fat ratio) and CT (IAF and ratio of IAF to subcutaneous abdominal fat [SAF]). Metabolic indicators were blood pressure, high-density lipoprotein cholesterol, triacylglycerol, fasting glucose, insulin, and high-sensitivity C-reactive protein. Metabolic syndrome (MS) was defined as the presence of at least two of the following: triacylglycerol level > or = 150 mg/dL, high-density lipoprotein cholesterol level <50 mg/dL, blood pressure > or = 130/85 mmHg, and/or fasting glucose level > or = 100 mg/dL. RESULTS: The correlations between adiposity measurements and metabolic indicators were stronger in premenopausal compared with postmenopausal women. Areas under the curve for MS and all abdominal adiposity measurements (WC, DXA-measured abdominal fat, and CT-derived IAF) were significant. Areas under the curve were not significantly different among measurements. The sensitivity and specificity at the threshold value of each abdominal adiposity measurement to predict MS were 38-93% and 34-96%, respectively. Women with 1 SD higher abdominal adiposity were 1.6-3.4 times more likely to have MS. CONCLUSION: No single abdominal adiposity measurement, i.e., WC, DXA-measured abdominal fat, and CT-assessed IAF, was a stronger predictor of metabolic risk factors than the other.     

Simple skinfold-thickness measurements complement conventional anthropometric assessments in predicting glucose tolerance

BACKGROUND: Skinfold-thickness measurements are considered to have limited clinical utility. OBJECTIVE: To assess whether skinfold-thickness measurements may be a useful adjunct to conventional anthropometric assessments in predicting glucose and insulin regulation, we studied responses to replicate 75-g oral-glucose-tolerance tests (OGTTs) and performed simple anthropometry in a cross section of subjects. DESIGN: Thirty-five subjects completed the study: 11 lean [mean (+/-SEM) age: 33 +/- 3.2 y; body mass index (BMI; in kg/m(2)): 24.1 +/- 0.8; and percentage body fat (%BF): 11.5 +/- 1.5%], 12 normal-weight (age: 33 +/- 2.9 y; BMI: 23.9 +/- 0.7; and %BF: 24.3.5 +/- 1.3%), and 12 obese (age: 41 +/- 4.5 y; BMI: 34.5 +/- 1.7; and %BF: 34.2 +/- 1.5%) individuals. The lean and normal-weight groups were selected to have similar BMIs but different %BFs. We measured the participants' heights, weights, %BFs, waist circumferences, hip circumferences, and truncal and peripheral skinfold thicknesses. Subjects received nine 75-g OGTTs and blood samples were collected at 0, 15, 30, 45, 60, 90, and 120 min. Mean plasma glucose and insulin values were used to calculate the insulin sensitivity index. RESULTS: The obese group had higher plasma glucose concentrations and areas under the curve (AUCs) than did the normal-weight or lean group and higher plasma insulin concentrations and AUCs than did the lean group (P < 0.05). Stepwise multiple regression, with adjustment for demographic and anthropometric measurements, identified the following predictors: waist circumference, peripheral skinfold thickness, and BMI for fasting plasma glucose (partial R(2) = 0.20, 0.13, and 0.13, P < 0.05); waist circumference and truncal skinfold thickness for plasma glucose AUC (partial R(2) = 0.20 and 0.13, P < 0.05); age, waist-to-hip ratio, and peripheral skinfold thickness for fasting plasma insulin (partial R(2) = 0.26, 0.22, and 0.15, P < 0.05); truncal skinfold thickness for plasma insulin AUC (partial R(2) = 0.41, P < 0.001); and peripheral skinfold thickness for both 2-h plasma glucose (partial R(2) = 0.59, P < 0.001) and the insulin sensitivity index (partial R(2) = 0.49, P < 0.001). CONCLUSION: Skinfold-thickness measurements may complement other established measurements for predicting abnormal glucose and insulin regulation.     

Adiposity measurements in association with metabolic syndrome in older men have different clinical implications

Obesity is a major public health problem, and measuring adiposity accurately and predicting its future comorbidities are important issues. Therefore, we hypothesized that 4 adiposity measurements, body mass index (BMI), waist circumference (WC), waist-to-height ratio, and body fat percentage, have different physiological meanings and distinct associations with adverse health consequences. This study aimed to investigate the relationship of these 4 measurements with metabolic syndrome (MetS) components and identify the most associated factor for MetS occurrence in older, non-medicated men. Cross-sectional data from 3004 men, all 65 years of age and older, were analyzed. The correlation and association between adiposity measurements and MetS components were evaluated by Pearson correlation and multiple linear regression. Based on multivariate logistic regression, BMI and WC were significantly associated with MetS and were selected to build a combined model of receiver operating characteristic curves to increase the diagnosis accuracy for MetS. The results show that BMI is independently associated with systolic and diastolic blood pressure; WC and body fat percentage are associated with fasting plasma glucose and log transformation of triglyceride; BMI and WC are negatively associated with high-density lipoprotein cholesterol (HDL-C); and WC is a better discriminate for MetS than BMI, although the combined model (WC + BMI) is not significantly better than WC alone. Based on these results, we conclude that the 4 adiposity measurements have different clinical implications. Thus, in older men, BMI is an important determinant for blood pressure and HDL-C. Waist circumference is associated with the risk of fasting plasma glucose, HDL-C, triglyceride, and MetS occurrence. The combined model did not increase the diagnosis accuracy.     

Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat

BACKGROUND: It is unknown whether the ability of waist circumference (WC) to predict health risk beyond that predicted by body mass index (BMI) alone is explained in part by the ability of WC to identify those with elevated concentrations of total or abdominal fat. OBJECTIVE: We sought to determine whether BMI and WC independently contribute to the prediction of non-abdominal (total fat - abdominal fat), abdominal subcutaneous, and visceral fat. DESIGN: Fat distribution was measured by magnetic resonance imaging in 341 white men and women. Multiple regression analysis was performed to measure whether the combination of BMI and WC explained a greater variance in non-abdominal, abdominal subcutaneous, and visceral fat than did BMI or WC alone. These fat depots were also compared after a subdivision of the cohort into 3 BMI (normal, overweight, and class I obese) and 3 WC (low, intermediate, and high) categories according to the classification system used to identify associations between BMI, WC, and health risk. RESULTS: Independent of age and sex, the combination of BMI and WC explained a greater variance in non-abdominal, abdominal subcutaneous, and visceral fat than did either BMI or WC alone (P < 0.05). For non-abdominal and abdominal subcutaneous fat, BMI was the strongest correlate; thus, by adding BMI to WC, the variance accrued was greater than when WC was added to BMI. However, when WC was added to BMI, the added variance explained for visceral fat was greater than when BMI was added to WC. Furthermore, within each of the 3 BMI categories studied, an increase in the WC category was associated with an increase in visceral fat (P < 0.05). CONCLUSIONS: BMI and WC independently contribute to the prediction of non-abdominal, abdominal subcutaneous, and visceral fat in white men and women. These observations reinforce the importance of using both BMI and WC in clinical practice.     

Are waist circumference and body mass index independently associated with cardiovascular disease risk in Chinese adults?

BACKGROUND: In Western populations, waist circumference (WC) is more predictive of cardiovascular disease (CVD) risk than is body mass index (BMI). It is unclear whether the same is true in Asian populations. OBJECTIVE: The objective was to examine the independent effects of WC and BMI on CVD risk factors in China. DESIGN: CVD risk factors, BMI, and WC were measured in a nationally representative cross-sectional study of 15 540 Chinese adults aged 35-74 y. RESULTS: Higher WC tertiles were associated with higher blood pressure and higher cholesterol, triacylglycerol, and glucose concentrations within each tertile of BMI and vice versa. In men, the odds of hypertension, dyslipidemia, and the metabolic syndrome (MS) increased with successive WC tertiles (1.0, 1.1, and 1.8, respectively, for hypertension; 1.0, 1.4, and 2.0, respectively, for dyslipidemia; and 1.0, 2.3, and 4.8, respectively, for MS; P for trend < 0.001 for all), even after adjustment for BMI. Similarly, the odds of hypertension, dyslipidemia, and MS increased with successive BMI tertiles (1.0, 1.5, and 2.6, respectively, for hypertension; 1.0, 1.3, and 1.8, respectively, for dyslipidemia; 1.0, 1.3, and 2.9, respectively for MS; P for trend < 0.001 for all), even after adjustment for WC. However, BMI tertiles were not associated with the odds of diabetes after adjustment for WC (P for trend = 0.67), whereas tertiles of WC were significantly associated with the odds of diabetes after adjustment for BMI (1.0, 1.6, and 2.1, respectively; P for trend = 0.002). The results were similar in women. CONCLUSIONS: These data show that WC adds additional risk information to that of BMI in Chinese adults. Measurement of both WC and BMI in Chinese adults may enhance CVD risk stratification.     

Correlation of dyslipidemia with waist to height ratio, waist circumference, and body mass index in Iranian adults

Overweight and obesity are increasing problems in many countries and are related to multiple cardiovascular risk factors. Although imaging techniques can determine total body fat and its distribution reliably, anthropometric measurements remain important in clinical practice. The purpose of this study was to determine the association between some anthropometric measurements and dyslipidemia as an important cardiovascular risk factor in Iranian population. A total of 750 subjects (580 females and 170 males) were selected by multistage random sampling from residents of Arak (Iran) and related villages in 2005. None of them had any significant past medical history. Body mass index(BMI), waist circumference(WC), and waist to height ratio(W/Ht) of subjects were measured to identify their relationship with their lipid profile including total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), and the ratio of total cholesterol to high density lipoprotein cholesterol(TC/HDL-C). Fasting blood sugar (FBS) was also measured. WC and W/Ht showed greater correlation with TC, TG, LDL-C, TC/HDL-C level than did BMI. Among lipid profile, TG showed the closest correlation with W/Ht (r=0.309, p<0.001) and WC (r=0.308, p<0.001). HDL-C level did not show any statistical relationship with W/Ht, but it was weakly correlated with WC (r=-0.088, p<0.05). None of the indices showed any association with FBS level. It can be concluded that W/Ht and WC can best predict dyslipidemia in an Iranian adult population. We suggest using both W/Ht and WC as inexpensive and easy methods in clinical and epidemiological fields.     

Effects of obesity and body fat distribution on lipids and lipoproteins in nondiabetic American Indians: The Strong Heart Study

OBJECTIVES: To examine the relationship between obesity and lipoprotein profiles and compare the effects of total obesity and central adiposity on lipids/lipoproteins in American Indians. RESEARCH METHODS AND PROCEDURES: Participants were 773 nondiabetic American Indian women and 739 men aged 45 to 74 years participating in the Strong Heart Study. Total obesity was estimated using body mass index (BMI). Central obesity was measured as waist circumference. Lipoprotein measures included triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein AI (apoAI), and apolipoprotein B (apoB). Partial and canonical correlation analyses were used to examine the associations between obesity and lipids/ lipoproteins. RESULTS: Women were more obese than men in Arizona (median BMI 32.1 vs. 29.2 kg/m2) and South Dakota and North Dakota (28.3 vs. 28.0 kg/m2), but there was no sex difference in waist circumference. Men had higher apoB and lower apoAI levels than did women. In women, when adjusted for center, gender, and age, BMI was significantly related to HDL cholesterol (r = -0.24, p < 0.001). There was a significant but weak relation with apoAI (r = -0.14, p < 0.001). Waist circumference was positively related to triglycerides (r = 0.14, p < 0.001) and negatively related to HDL cholesterol (r = -0.23, p < 0.001) and apoAI (r = -0.13, p < 0.001). In men, BMI was positively correlated with triglycerides (r = 0.30, p < 0.001) and negatively correlated with HDL cholesterol (r = -0.35, p < 0.001) and apoAI (r = -0.23, p < 0.001). Triglycerides increased with waist circumference (r = 0.30, p < 0.001) and HDL cholesterol decreased with waist circumference (r = -0.36, p < 0.001). In both women and men there was an inverted U-shaped relationship between obesity and waist with LDL cholesterol and apoB. In canonical correlation analysis, waist circumference received a greater weight (0.86) than did BMI (0.17) in women. However, the canonical weights were similar for waist (0.46) and BMI (0.56) in men. Only HDL cholesterol (-1.02) carried greater weight in women, whereas in men, triglycerides (0.50), and HDL cholesterol (-0.64) carried a large amount of weight. All the correlation coefficients between BMI, waist circumference, and the first canonical variable of lipids/lipoproteins or between the individual lipid/lipoprotein variables and the first canonical variable of obesity were smaller in women than in men. Triglycerides and HDL cholesterol showed clinically meaningful changes with BMI and waist circumference in men. All lipid/lipoprotein changes in women in relation to BMI and waist circumference were minimal. DISCUSSION: The main lipoprotein abnormality related to obesity in American Indians was decreased HDL cholesterol, especially in men. Central adiposity was more associated with abnormal lipid/lipoprotein profiles than general obesity in women; both were equally important in men.     

人体测量指标预测肥胖儿童非酒精性脂肪肝的研究

目的 研究人体测量指标对儿童肥胖伴非酒精性脂肪肝的预测作用,探讨不同指标筛查非酒精性脂肪肝的切点值。方法 选取自2018年6月—2019年12月在西安交通大学第二附属医院小儿内分泌门诊就诊的94例肥胖儿童为研究对象,进一步分为肥胖伴非酒精性脂肪肝组与肥胖不伴非酒精性脂肪肝组,52例正常儿童为对照组。测量身高(H)、体重(W)、腰围(WC)、臀围(HC)和血甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);行肝脏B超的检查。计算体质指数(BMI)、腰臀比(WHR)、腰高比(WHtR)、腹部体积指数(AVI)、脂质蓄积指数(LAP)和内脏脂肪指数(VAI)等指标。通过绘制人体测量指标的受试者工作特征曲线(ROC曲线)评估人体测量指标与肥胖儿童非酒精性脂肪肝的相关性,并比较各项人体测量指标的曲线下面积(AUC)确定切点值。结果 肥胖组BMI、WC、WHR、WHtR、AVI、LAP、VAI及TG均高于对照组(t=23.090、21.068、12.547、22.855、17.578、8.159、5.394、6.183,P＜0.001)。肥胖伴非酒精性脂肪肝组BMI、WC、AVI、LAP、VAI均高于肥胖不伴非酒精性脂肪肝组(t=2.180、2.389、2.362、3.643、2.839,P＜0.05)。人体测量指标的ROC曲线下面积按从大到小的顺序依次为 LAP、VAI、 WC、 AVI、 BMI。对肥胖伴非酒精性脂肪肝的联合诊断指标进行筛查效能分析结果显示,LAP+AVI 曲线下面积为0.706(95%CI:0.595~0.817,P＜0.001);AVI+VAI 曲线下面积为0.685(95%CI:0.570~0.800,P＜0.01);BMI+WC 曲线下面积为0.652(95%CI:0.537~0.768,P＜0.05)。联合指标的ROC曲线下面积从大到小为LAP+AVI、AVI+VAI、BMI+WC。结论 LAP联合AVI对儿童肥胖伴非酒精性脂肪肝具有较好的筛查作用。     

BMI与腰围对阻塞性睡眠呼吸暂停与2型糖尿病的中介效应

目的  探究BMI和腰围(waist circumference, WC)对阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)与2型糖尿病、糖代谢连续测量指标之间的中介效应。方法  纳入分析的1 615名研究对象来自动脉粥样硬化多民族研究(Multi-Ethnic Study of Atherosclerosis, MESA)。OSA评价指标为呼吸暂停低通气指数(apnea-hypopnea index,AHI),由多导睡眠图测定。糖代谢连续测量指标包括FPG和糖化血红蛋白(glycated hemoglobin,HbA1c)。肥胖指标包括全身肥胖指标BMI和腹型肥胖指标WC。结果  OSA与2型糖尿病显著相关,后者的患病风险随OSA严重程度增加而升高(P < 0.001)。BMI和WC均介导重度OSA与2型糖尿病之间的关联,其中腹型肥胖指标WC的中介效应为1.296(95% CI: 1.182~1.466),中介效应比例为56.397%;BMI的中介效应为1.291(95% CI: 1.173~1.479),中介效应比例为55.400%。BMI和WC同样介导重度OSA与FPG、HbA1c之间的关联。结论  OSA与2型糖尿病、FPG和HbA1c的关系,与肥胖程度增加有关。提示OSA患者通过早期的体重干预,特别是控制腹型肥胖对降低糖尿病和心血管并发症的患病率具有重要意义。     

Body mass index and waist circumference both contribute to differences in insulin-mediated glucose disposal in nondiabetic adults

BACKGROUND: Overweight and obese individuals are more likely to be insulin resistant and at increased risk of adverse clinical outcomes. Questions remain as to whether waist circumference (WC) or body mass index (BMI) most effectively identifies insulin-resistant individuals. OBJECTIVE: This study quantified insulin-mediated glucose uptake (IMGU) in 330 apparently healthy volunteers and compared the relation between this value and measurements of WC and BMI. DESIGN: IMGU was quantified via determination of the steady-state plasma glucose (SSPG) concentration during the insulin-suppression test. Differences in SSPG concentrations due to variations in WC within a given BMI category, as well as those due to differences in BMI within a given WC classification, were then compared. RESULTS: BMI and WC correlated with each other (r = 0.78, P < 0.001) and equally with SSPG concentrations (r = 0.58 and 0.57, respectively; P < 0.001). When stratified by BMI, abdominally obese subjects within the overweight BMI category had higher SSPG concentrations than did those with a normal WC (P < 0.05). When classified by WC, subjects in the overweight BMI category had greater SSPG concentrations than did subjects in the normal BMI category within the normal WC category (P < 0.01), as did subjects in the obese BMI category in comparison with subjects in the overweight BMI category within the obese WC category (P < 0.01). CONCLUSIONS: The more overweight or obese a person, the greater the degree of insulin resistance; differences in adiposity accounted for approximately one-third of the variation in IMGU, irrespective of the index used. Furthermore, there was no difference in the relation between the degree of insulin resistance and either index of adiposity.     

Waist Circumference and Testosterone Levels in Community Dwelling Men. The Tromsø Study

To examine the relationship of total and free testosterone and sex hormone-binding globulin (SHBG) with central obesity in men, we studied 1548 men aged 25–84 years that took part in the 1994–1995 survey of the Tromsø study. Total testosterone and SHBG were measured by immuno-assay and the free testosterone fraction was calculated. These measurements were analyzed in relation to anthropometric data and lifestyle factors. The age-adjusted correlation between waist circumference (WC) and total testosterone was ?0.34 (p < 0.001), between WC and free testosterone ?0.09 (p < 0.001) and, between WC and SHBG ?0.44 (p < 0.001). Adjusting for BMI and lifestyle factors weakened, but did not eliminate these associations. All hormone and SHBG associations were stronger for WC than for waist-hip ratio or BMI. In age- and BMI-adjusted analyses men with a WC ≥ 102 cm had significantly lower levels of total testosterone and SHBG compared to men with an optimal WC, defined as < 94 cm (12.3 vs. 13.9 nmol/l; p < 0.01 and 48.5 vs. 55.1 nmol/l; p < 0.001, respectively). The lowest levels of total and free testosterone were observed in men with relatively high WC despite relatively low overall obesity (BMI), suggesting that WC should be the preferred anthropometric measurement in predicting endogenous testosterone levels.     

1993-2009年7~18岁中国学龄儿童超重肥胖和腹型肥胖率变化趋势

【目的】 探讨1993-2009年7~18岁中国学龄儿童超重肥胖率和腹型肥胖率变化趋势。【方法】 选取1993、1997、2000、2004、2006和2009年“中国健康与营养调查”6次横断面调查数据,研究对象为7~18岁中国11 592名学龄儿童。研究内容包括性别、年龄、地区、身高、体重和腰围等。【结果】 7~18岁中国学龄儿童体质指数增加0.6 kg/m²(趋势P<0.001),腰围增加1 cm(趋势P<0.001);超重肥胖率从8.1%增加到18.0%(趋势P<0.001);腹型肥胖率从15.3%增加到28.9%(趋势P<0.001)。学龄儿童超重肥胖率及腹型肥胖率在不同性别、年龄及地区均显示出逐年增加的趋势(趋势P<0.001)。【结论】 17年来中国学龄儿童BMI、腰围、超重肥胖及腹型肥胖逐年增长,腹型肥胖的增加速度更为显著。因此,控制儿童肥胖迫在眉睫。     

Time spent being sedentary and weight gain in healthy adults: reverse or bidirectional causality?

BACKGROUND: Whether obesity is a cause or a consequence of a sedentary lifestyle has not yet been fully elucidated, which leaves uncertainty about the direction of causality. OBJECTIVE: We aimed to assess the longitudinal associations between objectively measured time spent being sedentary (sedentary time) and obesity indicators. DESIGN: The study was a prospective, population-based cohort study in 393 middle-aged healthy whites (n = 176 M, 217 F). Sedentary time (% of daytime hours) was measured by individually calibrated monitoring of the heart rate. Body weight (BW), body mass index (BMI), and waist circumference (WC) were assessed by standard clinical procedures. Fat mass (FM) was assessed with bioimpedance. All measurements were collected at baseline and at 5.6-y follow-up. RESULTS: At baseline, sedentary time was significantly correlated with FM (partial r = 0.10, P = 0.043) and WC (partial r = 0.11, P = 0.027) after adjustment for sex and age. At follow-up, sedentary time was significantly correlated with BW (partial r = 0.19, P < 0.0001), BMI (partial r = 0.20, P < 0.0001), WC (partial r = 0.15, P = 0.003), and FM (partial r = 0.19, P < 0.0001). Sedentary time did not predict any of the obesity indicators at follow-up. In contrast, BW (beta = 0.33; 95% CI: 0.15, 0.50), BMI (1.10; 0.58, 1.63), FM (0.59; 0.11, 0.40), and WC (0.44; 0.23, 0.66) predicted sedentary time at follow-up after adjustment for sex, baseline age, baseline sedentary time, baseline physical activity energy expenditure, and follow-up time. CONCLUSION: BMI, FM, and WC may predict sedentary time, but our results do not suggest that sedentary time predicts future obesity.     

Relation of serum lipoprotein lipids and apolipoproteins to obesity in children: the Bogalusa Heart Study.

BACKGROUND. The relationship of serum lipoprotein lipids and apolipoproteins to obesity was studied in a biracial sample of 2,816 children of ages 5-17 in Bogalusa, Louisiana. METHODS. Two measures of obesity were used: fatness (subscapular skinfold thickness) and fat centrality (the ratio of subscapular to triceps skinfold thickness). Plasma insulin and glucose were included as metabolic markers related to obesity. RESULTS. The obesity associations were relatively strong with insulin (rs = 0.29, P less than 0.001, skinfold; rs = 0.15, P less than 0.001, skinfold ratio) and triglycerides (rs = 0.25, P less than 0.001, skinfold; rs = 0.19, P less than 0.001, skinfold ratio). The relationships of serum low-density lipoprotein cholesterol (LDL-C) (rs = 0.17, P less than 0.001, skinfold; rs = 0.13, P less than 0.001, skinfold ratio) and apolipoprotein (apo) B (rs = 0.16, P less than 0.001, skinfold; rs = 0.13, P less than 0.001, skinfold ratio) with the obesity measures were of lesser magnitude, but persisted after adjustment for insulin and triglycerides. The inverse association of obesity to serum high-density lipoprotein cholesterol (HDL-C) (rs = -0.13, P less than 0.001, both skinfold and skinfold ratio) and apo A-I (rs = -0.04, P = 0.03, skinfold; rs = -0.05, P = 0.004, skinfold ratio) was significant only before adjustment for insulin and serum triglycerides. Multiple linear regression of obesity measures showed that, like insulin, serum triglycerides had consistently higher standardized coefficients than LDL-C, HDL-C, apo B, and apo A-I. Apo A-I and apo B added only a small amount (less than 2%) of information to the relationship of serum lipoproteins with obesity measures. CONCLUSION. These results indicate that serum very-low-density lipoprotein (VLDL) levels are directly and independently related to obesity. The well-known inverse association between obesity and serum HDL-C is not independent, but secondary to the elevated VLDL or triglyceride levels associated with obesity. While associations of obesity and lipoprotein cholesterol are found, far fewer occur with apolipoproteins, especially Apo A-I. Interesting race and sex differences in the relationship of obesity to serum lipoproteins and apoproteins are noted, being greater among white children and more consistent in white males.     

Waist circumference is a better predictor than body mass index of coronary heart disease risk in overweight premenopausal women

Waist circumference (WC) has been postulated to have stronger associations with biomarkers of coronary heart disease (CHD) than BMI. In this study, we measured the level of activity by determining steps walked per day and select biomarkers for CHD risk in 80 overweight or obese (BMI = 25-37 kg/m(2)) premenopausal women to evaluate whether these biomarkers are associated with WC or BMI. The plasma biomarkers measured, using samples from women who had fasted for 12 h, were lipids, apolipoproteins (apo), LDL peak diameter, LDL susceptibility to oxidation, glucose, leptin, and insulin. We identified subjects with the metabolic syndrome (11%) and insulin resistance (30%) to further distinguish subjects at increased risk for CHD. Both BMI and WC were positively correlated with insulin (r = 0.376 and 0.384, respectively, P < 0.05) and leptin (r = 0.614 and 0.512, respectively, P < 0.01) and negatively correlated with the number of steps taken per day (r = -0.245 and -0.354, respectively, P < 0.05). In addition, WC had positive correlations with diastolic blood pressure (r = 0.250, P < 0.05), plasma triglycerides (TG) (r = 0.270, P < 0.05), and apo C-III (r = 0.240, P < 0.05). Women with BMI > or = 30 kg/m(2) or WC > 88 cm had significantly higher leptin concentrations than women having a BMI < 30 kg/m(2) or a WC < or = 88 cm; women with WC > 88 cm also had higher diastolic pressure (P < 0.05), and higher plasma TG (P < 0.05) and apo C-III (P < 0.05) concentrations than those with WC < or = 88. In addition, subjects with the higher WC walked an average of 1000 fewer steps per day (P < 0.01). These results suggest that WC is a stronger predictor of CHD risk than BMI and is more closely associated with the level of exercise in premenopausal women.     

Parent-offspring body mass index associations in the Norwegian Mother and Child Cohort Study: a family-based approach to studying the role of the intrauterine environment in childhood adiposity

In the present study, the authors investigated the role of the intrauterine environment in childhood adiposity by comparing the maternal-offspring body mass index (BMI) association with the paternal-offspring BMI association when the offspring were 3 years of age, using parental prepregnancy BMI (measured as weight in kilograms divided by height in meters squared). The parent-offspring trios (n = 29,216) were recruited during pregnancy from 2001 to 2008 into the Norwegian Mother and Child Cohort Study conducted by The Norwegian Institute of Public Health. Data from self-administered questionnaires were used in linear regression analyses. Crude analyses showed similar parental-offspring BMI associations; the mean difference in offspring BMI was 0.15 (95% confidence interval: 0.13, 0.16) per each 1-standard-deviation increase in maternal BMI and 0.15 (95% confidence interval: 0.13, 0.17) per each 1-standard-deviation increase in paternal BMI. After all adjustments, the mean difference in offspring BMI per each 1-standard-deviation increment of maternal BMI was 0.12, and the mean difference in offspring BMI per each 1-standard-deviation increment of paternal BMI was 0.13. There was no strong support for heterogeneity between the associations (P > 0.6). In conclusion, results from the present large population-based study showed similar parental-offspring BMI associations when the offspring were 3 years of age, which indicates that the maternal-offspring association may be explained by shared familial (environmental and genetic) risk factors rather than by the intrauterine environment.     

Body mass index and hip and thigh circumferences are negatively associated with visceral adipose tissue after control for waist circumference

BACKGROUND: Waist circumference (WC) is positively associated with morbidity and mortality with or without control for hip circumference (HC) or body mass index (BMI; in kg/m(2)). This association is thought to be explained by an expanded visceral adipose tissue (VAT) depot. Conversely, HC and BMI are negatively associated with morbidity and mortality after control for WC. Whether this inverse association is explained in part by the ability of HC and BMI to identify subjects with increased subcutaneous adipose tissue (SAT), increased skeletal muscle (SM) mass, or decreased VAT after control for WC is unclear. OBJECTIVE: We examined the independent associations between WC, HC, thigh circumference (ThC), and BMI with VAT and total, lower-body, and abdominal SAT and SM. DESIGN: Total and regional body composition were measured in 256 white men and women with magnetic resonance imaging. RESULTS: WC, HC, ThC, and BMI were all positively correlated with total, lower-body, and abdominal SAT and SM and with VAT. After statistical control for WC, HC, ThC, and BMI remained positively associated with total, lower-body, and abdominal SAT and SM (men only) but were negatively associated with VAT (P < 0.05). HC (P < 0.05) but not BMI (P > 0.10) or ThC (P = 0.06) remained negatively associated with VAT after further control for age. CONCLUSIONS: HC, ThC, and BMI are positively associated with total, lower-body, and abdominal SAT and SM but negatively associated with VAT after control for WC. However, only HC remained negatively associated with VAT after control for age and WC.     

Association of waist circumference and body mass index with fasting blood insulin in severely obese children: a cross-sectional study

We tested whether body mass index (BMI) and waist circumference (WC) are associated with fasting insulin in severely obese children. A number of 391 (204 female and 187 male) obese children were consecutively enrolled in the study at a Paediatric outpatient clinic. They were aged 10+/-3 yr (mean+/-SD; range: 3-17 yr) and had a relative weight for age of 160+/-27% (mean+/-SD). BMI and WC explained respectively 9 and 13% of the variance of log-transformed (lt) insulin (p<0.0001 for both). After correction for age, however, BMI lost its association with lt-insulin (p=NS) and WC explained only 3% (p<0.001) of lt-insulin variance. Sex and pubertal status did not influence the relationship between WC, BMI and lt-insulin (p=NS, ANCOVA). We conclude that in severely obese children: 1) WC is a marginally better predictor of fasting blood insulin than BMI, 2) age has a substantial influence on the relationship between BMI, WC and insulin and, 3) the contribution of BMI and WC to insulin is of doubtful clinical relevance because it leaves a substantial portion (> or = 87%) of lt-insulin variance unexplained.     

Dietary patterns and markers of systemic inflammation among Iranian women

Few studies have examined the contribution of major dietary patterns to markers of systemic inflammation. This study was conducted to evaluate the association of major dietary patterns with markers of systemic inflammation among Iranian women. In a cross-sectional study of 486 healthy women aged 40-60 y, we assessed usual dietary intakes by means of an FFQ. Dietary patterns were identified by factor analysis. Anthropometric measurements were made and blood samples from fasting were taken for measuring inflammatory markers. The healthy pattern (high in fruits, vegetables, tomato, poultry, legumes, tea, fruit juices, and whole grains) was inversely related to plasma concentrations of C-reactive protein (CRP) (beta = -0.09, P < 0.001), E-selectin (beta = -0.07, P < 0.05), and soluble vascular cell adhesion molecule-1 (sVCAM-1) (beta = -0.08, P < 0.001) after control for potential confounders; with further adjustment for BMI and waist circumference (WC), the associations remained significant for CRP (beta = -0.05, P < 0.05) and sVCAM-1 (beta = -0.04, P < 0.05). In contrast, the western pattern score (high in refined grains, red meat, butter, processed meat, high-fat dairy, sweets and desserts, pizza, potato, eggs, hydrogenated fats, and soft drinks) was positively related to CRP (beta = 0.08, P < 0.001), serum amyloid A (SAA) (beta = 0.11, P < 0.05), IL-6 (beta = 0.09, P < 0.001), soluble intercellular adhesion molecule-1 (beta = 0.05, P < 0.05), and sVCAM-1 concentrations (beta = 0.07, P < 0.05). However, after additional control for BMI and WC, the associations remained significant only for SAA (beta = 0.06, P < 0.05) and IL-6 (beta = 0.07, P < 0.001). The traditional dietary pattern (high in refined grains, potato, tea, whole grains, hydrogenated fats, legumes, and casserole) was positively associated with the plasma IL-6 concentration (beta = 0.04, P < 0.05) when we controlled for confounders including BMI and WC. The findings suggest an independent association between major dietary patterns and plasma concentrations of markers of inflammation.     

天津市宝坻区老年人体质指数、腰围以及腰围身高比与高血压患病率的关联

  目的   探讨天津市宝坻区60岁及以上老年居民的体质指数(body mass index, BMI)、腰围(waist circumference, WC)以及腰围身高比(waist-to-height ratio, WHtR)与高血压患病率的关联。   方法   本研究对2018年4-5月参加天津市宝坻区口东卫生院体检的老年人(≥60岁)进行问卷调查和体格检查。采用分层分析和logistic回归分析BMI与WC(或WHtR)对高血压的联合作用和交互作用。   结果   共邀请1 692人, 1 417人(83.75%)参与本研究。老年人群的高血压患病率为46.36%、BMI超重和肥胖者占66.50%、WC中心型肥胖者占74.66%、WHtR超重和肥胖者占75.38%。与BMI或WC正常相比, BMI超重(OR=1.65, 95% CI:1.19~2.30)和肥胖(OR=3.41, 95% CI:2.23~5.20)及WC中心型肥胖(OR=1.49, 95% CI:1.00~2.23)均增加高血压的患病风险。BMI联合WC超重/肥胖(OR=2.49, 95% CI:1.78~3.46), 或BMI联合WHtR超重/肥胖(WHtR超重: OR=2.05, 95% CI:1.41~2.99;WHtR肥胖: OR=2.37, 95% CI:1.50~3.76)的患病风险高于后者单独作用的风险(WC超重/肥胖: OR=1.39, 95% CI:0.90~2.15;WHtR超重: OR=1.02, 95% CI:0.62~1.66;WHtR肥胖: OR=1.44, 95% CI:0.55~3.81)。   结论   三项指标中, BMI与高血压患病的关联性最强, 且BMI超重/肥胖增强WC(或WHtR)与高血压的关联, 提示控制BMI相关体重指标在正常范围内有助于预防和控制高血压。