Interaction effects of FTO rs9939609 polymorphism and lifestyle factors on obesity indices in early adolescence

BackgroundThe rs9939609 SNP in fat mass and obesity-associated (FTO) gene influence obesity, whose effects might be mediated by lifestyle factors. However, evidence was lacked in early adolescents. This study aimed to investigate the interactions effects of FTO rs9939609 and lifestyle factors on obesity indices in early adolescence.MethodsThe study included 1149 children aged 10–12 years. Their body mass index (BMI) and body fat percentage (BF%) were measured, and lifestyle factors were surveyed through questionnaires. The rs9939609 SNP in the FTO gene was genotyped.ResultsSignificant associations were found between FTO rs9939609 and obesity indices after adjusting for confounding factors. An interaction effect between rs9939609 and soft drinks was observed with p = 0.019 for BMI after adjustment for confounding factors. The children carrying risk allele A had a significantly higher mean BMI (mean=19.67kg/m²) than those carrying only the wild allele T (mean = 17.987 kg/m²) when they reported a higher intake of soft drinks (≥3 times/week), but the association was not observed among children with a lower intake of soft drinks. No significant interactions were established between appetite, weekday TV viewing, sleep, exclusive breast feeding in the first four months and FTO rs9939609 on BMI or BF%. Bioinformatics revealed that rs9939609 and its linkage disequilibrium (LD) SNPs are potentially implicated in the regulation of gene expression in blood, pancreatic and brain tissue cells.ConclusionFTO rs9939609 had an obvious and independent effect on obesity-related indices in early adolescents. Soft drinks may exert a modifying effect on the relationship between FTO rs9939609 and BMI.     

Role of disability in the association between obesity and unintentional injuries

BackgroundWe assessed the mediating role of disability in the association between obesity and elevated injury risk among U.S. white and African American adults.MethodsData from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analyzed. Respondents were categorized into 6 groups: underweight (<18.5 kg/m²), normal weight (18.5-24.9 kg/m²), overweight (25.0-29.9 kg/m²), obese class I (30.0-34.9 kg/m²), obese class II (35.0-39.9 kg/m²), and obese class III (≥40 kg/m²). Responses to the 12 items in SF-12v2 were used to transform raw scales to the norm-based Physical Component Summary measure (PCS). Disability was defined as having a PCS score below 30 (mean, −2.00 SD). Self-reported unintentional injuries in the past 12 months were compared between respondents with and without disability within each body mass index (BMI) category. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were examined for men and women separately using 3 logistic regression models that considered age, race, education level, poverty status, chronic medical conditions, major injury risk behaviors, obesity, and disability status.ResultsA total of 31,276 non-Hispanic white and African American respondents reported an injury incidence of 18.6%. Disability correlated with significantly higher injury incidence (p < .01). Controlling for major sociodemographics, chronic medical conditions, and major injury risk behaviors, we observed a statistically significant association between obesity and injuries (OR = 1.27, 95% CI = 1.06-1.54, for BMI ≥ 40; OR = 1.11, 95% CI = 1.01-1.23, for BMI of 30.0 to <40) among women; however, this association became nonsignificant after status of disability was considered in the final regression model. This finding was not seen for men.ConclusionThe elevated injury risk among white and African American women with extreme obesity was mediated substantially by disability. No such finding was found, however, for men.     

Carrot Consumption Frequency Associated with Reduced BMI and Obesity through the SNP Intermediary rs4445711

It is unclear whether genetic interactions are involved in the association between vegetable intake and reduced body mass index (BMI) or obesity. We conducted a comprehensive search for single nucleotide polymorphisms (SNPs) which are associated with the interaction between vegetable intake frequency and BMI or obesity. We performed a genome-wide association analysis to evaluate the genetic interactions between self-reported intake of vegetables such as carrot, broccoli, spinach, other green vegetables (green pepper and green beans), pumpkin, and cabbage with BMI and obesity, which is defined as a BMI ≥ 25.0 kg/m² in the Japanese population (n = 12,225). The mean BMI and prevalence of obesity was 23.9 ± 3.4 kg/m² and 32.3% in men and 22.1 ± 3.8 kg/m² and 17.3% in in women, respectively. A significant interaction was observed between rs4445711 and frequency of carrot intake on BMI (p = 4.5 × 10⁻⁸). This interaction was slightly attenuated after adjustment for age, sex, alcohol intake, smoking, physical activity and the frequency of total vegetable intake (p = 2.1 × 10⁻⁷). A significant interaction was also observed between rs4445711 and frequency of carrot intake on obesity (p = 2.5 × 10⁻⁸). No significant interactions that were the same as the interaction between frequency of carrot intake and rs4445711 were observed between the intake frequency of broccoli, spinach, other green vegetables, pumpkin or cabbage and BMI or obesity. The frequency of carrot consumption is implicated in reducing BMI by the intermediary of rs4445711. This novel genetic association may provide new clues to clarify the association between vegetable intake and BMI or obesity.     

Genome-wide association study for the interaction between BMR and BMI in obese Korean women including overweight

BACKGROUND/OBJECTIVESThis is the first study to identify common genetic factors associated with the basal metabolic rate (BMR) and body mass index (BMI) in obese Korean women including overweight. This will be a basic study for future research of obese gene-BMR interaction.SUBJECTS/METHODSThe experimental design was 2 by 2 with variables of BMR and BMI. A genome-wide association study (GWAS) of single nucleotide polymorphisms (SNPs) was conducted in the overweight and obesity (BMI > 23 kg/m²) compared to the normality, and in women with low BMR (< 1426.3 kcal/day) compared to high BMR. A total of 140 SNPs reached formal genome-wide statistical significance in this study (P < 1 × 10^-4). Surveys to estimate energy intake using 24-h recall method for three days and questionnaires for family history, a medical examination, and physical activities were conducted.RESULTSWe found that two NRG3 gene SNPs in the 10q23.1 chromosomal region were highly associated with BMR (rs10786764; P = 8.0 × 10^-7, rs1040675; 2.3 × 10^-6) and BMI (rs10786764; P = 2.5 × 10^-5, rs10786764; 6.57 × 10^-5). The other genes related to BMI (HSD52, TMA16, MARCH1, NRG1, NRXN3, and STK4) yielded P <10 × 10^-4. Five new loci associated with BMR and BMI, including NRG3, OR8U8, BCL2L2-PABPN1, PABPN1, and SLC22A17 were identified in obese Korean women (P < 1 × 10^-4). In the questionnaire investigation, significant differences were found in the number of starvation periods per week, family history of stomach cancer, coffee intake, and trial of weight control in each group.CONCLUSIONWe discovered several common BMR- and BMI-related genes using GWAS. Although most of these newly established loci were not previously associated with obesity, they may provide new insights into body weight regulation. Our findings of five common genes associated with BMR and BMI in Koreans will serve as a reference for replication and validation of future studies on the metabolic rate.     

The role of the genetic variants IRX3 rs3751723 and FTO rs9939609 in the obesity phenotypes of children and adolescents

ObjectiveWe investigated the association of IRX3 SNP rs3751723 with anthropometric characteristics related to adiposity and potential relationships with FTO SNP rs9939609 in a population of Brazilian children and adolescents.MethodsA total of 871 children and adolescents between 7 and 17 years of age were recruited. Adiposity measurements and biochemical parameters were assessed. The variants were genotyped by real-time PCR. Analysis of multiple linear regression, multiple logistic regression, and generalised multifactor dimensionality reduction (GMDR) adjusted for sex, age and ethnicity were applied to test the polymorphisms association with obesity-related phenotypes and the interaction between them.ResultsThe analyses showed that IRX3 was associated with obesity and fat percentage (BF%). An association of FTO rs9939609 with body mass index (BMI) Z-Score and with waist circumference (WC) was detected. The odds ratios (OR) showed that IRX3 rs3751723 was associated with risk of obesity in additive model (p = 0.017), recessive model (p = 0.016) and with high BF% in all models. FTO rs9939609 was associated with risk of obesity in additive model (p = 0.031), recessive (p = 0.033) and with altered WC in all models. GMDR-based predictive models for the risk of obesity, altered WC and high BF% adjusted by age, ethnicity and sex suggested no interaction of the two loci.ConclusionsThe genetic variants rs3751723 and rs9939609 have an influence on the characteristics of adiposity; however, the effects of IRX3 and FTO investigated polymorphisms are independent in relation to adiposity parameters.     

Peer Reviewed: The Association Between Body Mass Index and Arthritis Among US Adults: CDC’s Surveillance Case Definition

Introduction

The Centers for Disease Control and Prevention modified the surveillance case definition of arthritis to a more stringent form in 2002. To date, the association between arthritis and obesity (an established risk factor for arthritis) has not been examined with the new definition. We describe the association between body mass index (BMI) (kg/m²) and arthritis using the new arthritis case definition to provide a more accurate assessment of the relationship between weight and arthritis among US adults.

Methods

We used data from the 2005 Behavioral Risk Factor Surveillance System (N = 356,112) and univariate and multivariate analyses to assess the relationship between BMI and arthritis among US adults.

Results

Overall, 26% of US adults had self-reported arthritis. Obese respondents (BMI ≥30.0 kg/m²) were 1.9 times more likely to report arthritis compared with normal-weight respondents (BMI <25.0 kg/m²), and distinguishing between obese levels revealed an even greater association between BMI and arthritis (class III obesity [BMI ≥40.0], odds ratio [OR] = 3.3, 95% confidence interval [CI] = 3.1-3.6; class II obesity [BMI 35.0-39.9 kg/m²], OR = 2.5, 95% CI = 2.3-2.7; class I obesity [BMI 30.0-34.9], OR = 1.9, 95% CI = 1.8-2.0).

Conclusion

BMI is an independent risk factor for self-reported arthritis. Maintaining a healthy weight may delay the onset of arthritis. More research is needed to determine the effect of weight loss on the progression of arthritis in overweight individuals.     

The missense variant,rs373863828, in CREBRF plays a role in longitudinal changes in body mass index in Samoans

ObjectiveA missense variant, rs373863828, in CREBRF is associated with obesity in Polynesians. We investigate whether rs373863828 and other factors are associated with body mass index (BMI) rate-of-change between 2010 and 2017–19 in Samoans.MethodsWe used sex-stratified models to test whether BMI rate-of-change was associated with rs373863828, baseline BMI, age, residence, physical activity, and household asset score in a cohort study of 480 Samoan adults measured in both 2010 (mean age 43.8 years) and 2017–19.ResultsMean BMI increased from 32.1 to 33.5 kg/m² in males (n = 220, p = 1.3 ×10^?8) and from 35.9 to 37.8 kg/m² in females (n = 260, p = 1.2 ×10^?13). In females, the A allele was associated with a higher rate-of-change (0.150 kg/m²/year/allele, p = 1.7 ×10^?4). Across 10-year age groups, mean BMI rate-of-change was lower in older participants. The BMI rate of change differed by genotype: it was, in females with AA genotype, approximately half that seen in GG and AG participants. In females lower baseline household asset scores were associated with a higher rate-of-change (p = 0.002).ConclusionsIn Samoans, the minor A allele of rs373863828 is associated with an increased rate-of-change in BMI in females. On average, BMI of females with the AA genotype increased 0.30 kg/m²/year more than of those with the GG genotype.     

Does there exist an obesity paradox in COVID-19? Insights of the international HOPE-COVID-19-registry

BackgroundObesity has been described as a protective factor in cardiovascular and other diseases being expressed as ‘obesity paradox’. However, the impact of obesity on clinical outcomes including mortality in COVID-19 has been poorly systematically investigated until now. We aimed to compare clinical outcomes among COVID-19 patients divided into three groups according to the body mass index (BMI).MethodsWe retrospectively collected data up to May 31^st, 2020. 3635 patients were divided into three groups of BMI (<25 kg/m²; n = 1110, 25?30 kg/m²; n = 1464, and >30 kg/m²; n = 1061). Demographic, in-hospital complications, and predictors for mortality, respiratory insufficiency, and sepsis were analyzed.ResultsThe rate of respiratory insufficiency was more recorded in BMI 25?30 kg/m² as compared to BMI < 25 kg/m² (22.8% vs. 41.8%; p < 0.001), and in BMI > 30 kg/m² than BMI < 25 kg/m², respectively (22.8% vs. 35.4%; p < 0.001). Sepsis was more observed in BMI 25?30 kg/m² and BMI > 30 kg/m² as compared to BMI < 25 kg/m², respectively (25.1% vs. 42.5%; p = 0.02) and (25.1% vs. 32.5%; p = 0.006). The mortality rate was higher in BMI 25?30 kg/m² and BMI > 30 kg/m² as compared to BMI < 25 kg/m², respectively (27.2% vs. 39.2%; p = 0.31) (27.2% vs. 33.5%; p = 0.004). In the Cox multivariate analysis for mortality, BMI < 25 kg/m² and BMI > 30 kg/m² did not impact the mortality rate (HR 1.15, 95% CI: 0.889?1.508; p = 0.27) (HR 1.15, 95% CI: 0.893?1.479; p = 0.27). In multivariate logistic regression analyses for respiratory insufficiency and sepsis, BMI < 25 kg/m² is determined as an independent predictor for reduction of respiratory insufficiency (OR 0.73, 95% CI: 0.538?1.004; p = 0.05).ConclusionsHOPE COVID-19-Registry revealed no evidence of obesity paradox in patients with COVID-19. However, Obesity was associated with a higher rate of respiratory insufficiency and sepsis but was not determined as an independent predictor for a high mortality.     

Interactions between the FTO rs9939609 polymorphism,body mass index,and lifestyle-related factors on metabolic syndrome risk

Whether the FTO polymorphisms interact with environmental factors has not yet been evaluated in associations with metabolic syndrome (MS) risk. The present study investigated the association of the FTO rs9939609 genotypes, body mass index (BMI), and lifestyle-related factors including smoking, alcohol drinking, physical activity, and diet with MS incidence. A population-based prospective cohort study comprised 3,504 male and female Koreans aged 40 to 69 years. At the beginning of the study, all individuals were free of MS and known cardiovascular disease. Incident cases of MS were identified by biennial health examinations during a follow-up period from April 17, 2003 to April 15, 2009. Pooled logistic regression analysis was applied to obtain relative odds (RO) of MS with its 95% confidence interval (CI). After controlling for potential MS risk factors, we observed no association between the rs9939609 genotypes and MS incidence. In analysis stratified by BMI, however, carriers with the FTO risk allele whose BMI is 29 kg/m² or greater showed an approximately 6-fold higher RO (95% CI: 3.82 to 9.30) compared with non-carriers with BMI less than 25 kg/m². In particular, the association between the rs9939609 variants and MS risk was significantly modified by high BMI (P-value for interaction < 0.05). Such significant interaction appeared in associations with central obesity and high blood pressure among the MS components. Because carriers of the FTO risk alleles who had BMI of 29 kg/m² or greater are considered a high risk population, we suggest that they may need intensive weight loss regimens to prevent MS development.     

The impact of CPT1B rs470117, LEPR rs1137101 and BDNF rs6265 polymorphisms on the risk of developing obesity in an Italian population

ObjectiveThis study aimed to analyze 11 single nucleotide polymorphisms (SNPs) belonging to 9 genes involved in metabolic pathways (BDNF rs6265; PNPLA3 rs2294918 and rs2076212; CIDEA rs11545881; NTRK2 rs2289658; ALOX12 rs1126667; ALOX12B rs2304908; LEPR rs1137101; CPT1B rs470117 and rs8142477; rs2305507 CPT1A) in obese patients and controls.MethodsPolymorphisms were analyzed in 300 severe obese patients undergoing bariatric surgery (body mass index >30 kg/m²) and 404 control subjects in order to evaluate their association with obesity and clinical variables.ResultsOur findings showed significant differences for the allelic distributions of CPT1B rs470117 and LEPR rs11371010 in obese subjects compared to controls. The BDNF rs6265 correlates with obesity only when associated with the other two SNPs. In particular, for CPT1B rs470117 and LEPR rs1137101, the rare allele was associated with a reduced risk of developing the obese phenotype, whereas the simultaneous presence of the common C allele for rs470117 and A allele for rs1137101 was more frequent in obese patients (p = 0.002, OR = 1.417). A significant association between CPT1B rs470117 and steatosis was found. Moreover, we observed that by associating the rare allele T of the BDNF rs6265 with the most common alleles of the SNPs CPT1B rs470117 and LEPR rs1137101, the combination of T-C-A alleles was associated with a higher risk of developing an obese phenotype (p = 0.001, OR = 1.6679).ConclusionsOur results suggest that SNPs CPT1B rs470117 and LEPR rs1137101 taken individually and in association with BDNF rs6265 may be involved in an increased risk of developing obese phenotype in an Italian cohort.     

Sleep Duration and Weight Gain: Reconsideration by Panel Data Analysis

Background

Inconsistent findings in previous studies of the association between sleep duration and changes in body mass index (BMI) may be attributed to misclassification of sleep duration fluctuations over time and unmeasured confounders such as genetic factors. The aim of the present study was to overcome these failings by using repeated measurements and panel data analysis to examine the sleep-BMI association.

Methods

Panel data were derived by secondary use of the data from mandatory health checkups at a Japanese gas company. Male non-shift workers aged 19–39 years in 2007 were annually followed until 2010 (n = 1687, 6748 records). BMI was objectively measured, and sleep duration was self-reported.

Results

Compared with 7-hour sleepers, panel analysis with the population-averaged model showed a significant increase in BMI among 5-hour (0.11 kg/m², P = 0.001), 6-hour (0.07 kg/m², P = 0.038), and ≥8-hour (0.19 kg/m², P = 0.009) sleepers. On the other hand, after adjustment for unobserved time-invariant confounders using the fixed-effects model, the magnitude of the association was considerably attenuated and no longer significant (5-hour, 0.07 kg/m², P = 0.168; 6-hour, 0.02 kg/m², P = 0.631; ≥8-hour sleepers, 0.06 kg/m², P = 0.460).

Conclusions

The longitudinal association between sleep duration and changes in BMI may be upwardly biased by unobserved time-invariant confounders rather than misclassified sleep duration. The net effect of sleep duration on weight gain may therefore be less than previously believed.Key words: longitudinal studies, sleep, obesity, weight gain, panel analysis     

Elevated body mass index increases the risk of cardiovascular events in hypertensive patients accompanied with obstructive sleep apnea: A cohort study

BackgroundEffects of body mass index (BMI) on cardiovascular events are inconsistent. We aimed to investigate the association of BMI with cardiovascular events in hypertensives with obstructive sleep apnea (OSA).MethodsHypertensives with OSA diagnosed with polysomnography between 2011 and 2013 in UROSAH cohort were followed up till Jan 2021. Outcomes were non-fatal cardiovascular events and cardiac death. Cox regression was used to estimate the relationship of continuous and categorical BMI with total and specific outcomes. Sensitivity analyses were performed by excluding those on OSA treatment or underweight patients. Stratified analyses were conducted by parameters including sex and age.Results2239 hypertensives with OSA were included with 405 normal weight (BMI<25 kg/m²), 1164 overweight (25–29.9 kg/m²) and 670 obesity (≥30 kg/m²). 206 non-fatal cardiovascular events and 18 cardiac death were recorded during 6.6 years follow-up. Compared with normal weight group, overweight (HR=1.53, 95%CI: 1.01–2.32, P = 0.047) and obesity groups (1.85, 1.19–2.86, P = 0.006) showed increased risk for cardiovascular events, significant in obesity group and marginal in overweight group in fully-adjusted model. In specific events, obesity showed significantly elevated HR for non-fatal cardiovascular events (1.64, 1.04–2.60, P = 0.035). Continuous BMI showed significantly increased HR for total and specific events in all models. Sensitivity analysis yielded consistent results. In stratification analysis, stronger association between obesity and cardiovascular events was observed in the young (HR=5.97, P interaction=0.030).ConclusionsBMI is in positive association with cardiovascular events in hypertensives with OSA, emphasizing importance of maintaining healthy BMI for prevention of adverse events in this population, on the basis of guideline-recommended treatment.     

中国成年人代谢异常相关的体质指数和腰围切点研究

目的 研究中国成年人BMI和腰围与各项代谢危险因素之间的相关性,确定超重肥胖的适宜BMI和腰围切点。方法 中国慢性病前瞻性研究于2004-2008年进行基线调查,并于2013-2014年随机抽取了5%的研究对象进行第2次重复调查。本研究剔除体格指标或代谢危险因素变量缺失或极端值、自报患有恶性肿瘤者,基线纳入501 201人,第2次重复调查纳入19 201人。比较不同BMI和腰围下代谢危险因素异常率,通过受试者工作特征（ROC）曲线分析,确定预测高血压、糖尿病、血脂异常和危险因素聚集的适宜BMI和腰围切点。结果 随BMI或腰围的增加,高血压、糖尿病、血脂异常和危险因素聚集患病率均呈现上升的趋势。依据正确指数最大的原则选取BMI超重切点和腰围切点,男性和女性BMI超重切点均接近24.0 kg/m²,男性腰围切点接近85 cm,女性腰围切点约为80~85 cm。男性和女性中,检出各项代谢危险因素特异度达到90%的BMI切点范围为27.0~28.9 kg/m²,多数接近28.0 kg/m²,以28.0 kg/m²作为肥胖切点。结论 本研究在更新开展的大样本调查中进一步验证了中国肥胖问题工作组2002年推荐的超重和肥胖标准,超重和肥胖的BMI切点分别为24.0和28.0 kg/m²;中心性肥胖的腰围适宜切点男性为85 cm,女性为80~85 cm。     

Maternal Diet Quality,Body Mass Index and Resource Use in the Perinatal Period: An Observational Study

The impact of pre-pregnancy obesity and maternal diet quality on the use of healthcare resources during the perinatal period is underexplored. We assessed the effects of body mass index (BMI) and diet quality on the use of healthcare resources, to identify whether maternal diet quality may be effectively targeted to reduce antenatal heath care resource use, independent of women’s BMI. Cross-sectional data and inpatient medical records were gathered from pregnant women attending publicly funded antenatal outpatient clinics in Newcastle, Australia. Dietary intake was self-reported, using the Australian Eating Survey (AES) food frequency questionnaire, and diet quality was quantified from the AES subscale, the Australian Recommended Food Score (ARFS). Mean pre-pregnancy BMI was 28.8 kg/m² (range: 14.7 kg/m²–64 kg/m²). Mean ARFS was 28.8 (SD = 13.1). Higher BMI was associated with increased odds of caesarean delivery; women in obese class II (35.0–39.9 kg/m²) had significantly higher odds of caesarean delivery compared to women of normal weight, (OR = 2.13, 95% CI 1.03 to 4.39; p = 0.04). Using Australian Refined Diagnosis Related Group categories for birth admission, the average cost of the birth admission was $1348 more for women in the obese class II, and $1952 more for women in the obese class III, compared to women in a normal BMI weight class. Higher ARFS was associated with a small statistically significant reduction in maternal length of stay (RR = 1.24, 95% CI 1.00, 1.54; p = 0.05). There was no evidence of an association between ARFS and mode of delivery or “midwifery-in-the-home-visits”.     

Medical costs attributable to overweight and obesity in Japanese individuals

ObjectiveWe aimed to reveal the association between body mass index (BMI) and medical costs in the current Japanese population, and to estimate the population attributable fraction (PAF) of medical costs due to overweight and obesity.MethodsA generalized linear mixed model with log link function and gamma distribution was used to evaluate the association between BMI and medical costs in 34,537 beneficiaries of the National Health Insurance aged 40–69 years in Chiba City. Medical cost data were obtained from insurance claims submitted between April 2012 and March 2016. PAFs due to overweight (BMI ≥25.0 and <30.0 kg/m²) and obesity (BMI ≥30.0 kg/m²) were calculated.ResultsOverweight and obesity were significant predictors of excessive medical costs in all age and sex groups. PAF due to overweight and obesity was estimated to be 9.62% (95% confidence interval, 8.52–10.73%). Additionally, PAFs in 40–59-year-old individuals (12.76% in men and 11.63% in women) were greater than those in 60–69-year-old subjects (6.55% in men and 7.80% in women) for both sexes.ConclusionsIn the Japanese population, overweight and obesity are an excessive financial burden with an estimated PAF of 9.62% of total medical costs.     

Body mass index and risk of head and neck cancer by race: the Carolina Head and Neck Cancer Epidemiology Study

PurposeMost studies, primarily conducted in populations of European ancestry, reported increased risk of head and neck cancer (HNC) associated with leanness (body mass index [BMI] <18.5 kg/m²) and decreased for overweight or obesity (25.0 to <30.0 and >30 kg/m², respectively), compared with normal weight (18.5 to <25.0 kg/m²).MethodsThe Carolina Head and Neck Cancer Epidemiology Study is a population-based, racially diverse case-control study of 1289 incident HNC cases (330 African Americans) and 1361 controls (261 African Americans). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between BMI 1 year prediagnosis and HNC risk stratified by race and adjusted for age, sex, smoking, alcohol, and education.ResultsMultiplicative interaction between BMI and race was evident (P_int = .00007). Compared with normal weight, ORs for leanness were increased for African Americans (OR, 3.91; 95% CI, 0.72–21.17) and whites (OR, 1.48; 95% CI, 0.60–3.65). For overweight and obesity, ORs were decreased in African Americans (OR, 0.51; 95% CI, 0.32–0.83 and OR, 0.47; 95% CI, 0.28–0.79, respectively) but in not whites. The increased risk associated with leanness was greater for smokers than nonsmokers (P_int = .02).ConclusionsThese data, which require replication, suggest that leanness is associated with increased HNC risk among African Americans to a greater extent than whites and overweight and obesity is associated with decreased HNC risk only among African Americans.     

Prevalence and factors affecting underweight,overweight and obesity using Asian and World Health Organization cutoffs among adults in Nepal: Analysis of the Demographic and Health Survey 2016

ObjectiveThere is a little published data on prevalence and determinants of underweight, overweight and obesity among adults in Nepal. This study analysed the cross-sectional Nepal Demographic and Health Survey (NDHS) 2016 to obtain these using the World Health Organization (WHO) and Asian-specific cutoffs of body mass index (BMI).MethodsThe 2016 NDHS used a multistage cluster-sampling design to obtain data on major health indicators in Nepal. The BMI cutoffs for underweight was <18.5 kg/m². The BMI cutoffs for overweight/obesity as per the Asian and WHO classifications were ≥23, and ≥25 kg/m², respectively. After reporting the prevalence according to sex and background characteristics, multilevel logistic regression was conducted to estimate odds ratios.SubjectsThis analysis included 12,652 adults (5283 males and 7369 females) with a median age of 40 years (interquartile range [IQR]: 28–54).ResultsThe overall median BMI was 21.5 kg/m² (IQR:19.3–24.3). The overall prevalence of underweight was 16.7% (15.1% among males and 17.1% among females). The Asian-specific BMI cutoffs found the prevalence of overweight and obesity as 26.4% (27.4% among males and 25.6% among females) and 11.0% (7.7% among males and 13.3% among females), respectively. The WHO-recommended BMI cutoffs found 18.2% people overweight (16.7% among males and 19.3% among females) and 4.3% (2.5% among males and 5.6% among females) people obese. The prevalence and odds of extreme body weight categories (i.e., underweight, overweight and obesity) varied according to age, sex, education level, household wealth status, place, ecological zone and provinces of residence as per both recommended cutoffs. Overall, higher education level and wealth status were positively associated with overweight/obesity and inversely associated with underweight as per both cutoffs.ConclusionA large proportion Nepalese adults have either underweight, overweight or obesity, and could be at a greater risk of mortality and morbidity due to these extreme body weight categories. It is essential to address the factors or characteristics that are associated with the higher prevalence and likelihood of these extreme body weight categories to reduce the overall burden of underweight and overweight/obesity in Nepal.     

不同肥胖测量指标与成年女性血清C反应蛋白的关联研究

目的 探讨不同的肥胖测量指标对中国成年女性血清C反应蛋白(CRP)的关联。方法 数据来源于成都市双流区城镇乳腺癌筛查项目基线调查及随访调查,共纳入441名成年女性。对研究对象开展问卷调查、体格检查和实验室检测。采用多因素logistic回归模型、两水平线性混合效应模型和限制性立方样条模型探讨不同肥胖测量指标与成年女性血清CRP的线性和非线性关联。结果 BMI、腰围和体脂率每增加1个单位,成年女性血清CRP升高即慢性低度炎症状态加重的风险分别增加16.5%、5.0%和11.1%(P<0.05)。BMI和体脂率与血清CRP之间存在非线性关联,以BMI=24.0 kg/m²为参考点,当BMI>24.0 kg/m²时,血清CRP水平随BMI的增加而增加;以体脂率=30%为参考点,当体脂率>30%时,血清CRP水平随体脂率的增加而增加。结论 BMI反映的整体肥胖与成年女性血清CRP关联最强,体脂率反映的体脂含量与血清CRP关联强度次之,腰围反映的中心性肥胖与血清CRP关联相对最弱。BMI>24.0 kg/m²和体脂率>30%的成年女性是产生肥胖相关炎性表现的高危险人群。     

中国慢性病前瞻性研究:10个项目地区成年人超重/肥胖现况分析

目的 描述中国慢性病前瞻性研究(CKB)项目10个地区人群超重/肥胖现状的地区差异。方法 CKB项目于2004－2008年在城市和农村各5个地区募集30～79岁队列成员并完成基线调查,剔除BMI异常个体后,分析10个地区中512 489名队列成员基线调查时的BMI和WC及其对应的超重/肥胖和中心性肥胖分组情况的地区差异。结果 10个地区女性的超重/肥胖(45.3%)和中心性肥胖(44.6%)水平均高于男性(41.7%和38.3%)。青岛项目点人群的超重/肥胖率(男性为66.9%,女性为67.5%)和中心性肥胖率(男性为63.3%,女性为64.9%)均为最高。超重/肥胖的地区差异在男性中更为明显;除河南以外的农村项目点超重/肥胖率相对较低。在BMI< 24.0 kg/m²的非超重/肥胖人群中,部分个体达到中心性肥胖标准(男性为9.8%,女性为15.3%);该比例在青岛项目点更高(男性为22.2%,女性为23.2%)。结论 CKB项目10个地区研究人群的超重/肥胖情况存在明显的地区差异。     

The Association Between Metabolic Syndrome and Colorectal Cancer Risk by Obesity Status in Korean Women: A Nationwide Cohort Study

ObjectivesThis study aimed to determine the association between metabolic syndrome (MetS) and the incidence of colorectal cancer (CRC) in Korean women with obesity.MethodsCancer-free women (n=6 142 486) aged 40–79 years, who underwent National Health Insurance Service health examinations in 2009 and 2010 were included. The incidence of CRC was followed until 2018. The hazard ratio (HR) of MetS for the incidence of colon and rectal cancer was analyzed according to body mass index (BMI) categories, adjusting for confounders such as women’s reproductive factors. In addition, the heterogeneity of associations across BMI categories was assessed.ResultsWomen with MetS were at increased risk of colon and rectal cancer compared to women without MetS (HR, 1.20; 95% confidence interval [CI], 1.16 to 1.23 and HR,1.15; 95% CI, 1.11 to 1.20), respectively. The HR of MetS for colon cancer across BMI categories was 1.12 (95% CI, 1.06 to 1.19), 1.14 (95% CI, 1.08 to 1.20), and 1.16 (95% CI, 1.12 to 1.21) in women with BMIs <23.0 kg/m², 23.0–24.9 kg/m², and ≥25.0 kg/m², respectively. The HR of MetS for rectal cancer across corresponding BMI categories was 1.16 (95% CI, 1.06 to 1.26), 1.14 (95% CI, 1.05 to 1.23), and 1.13 (95% CI, 1.06 to 1.20). The heterogeneity of associations across BMI categories was not significant in either colon or rectal cancer (p=0.587 for colon cancer and p=0.927 for rectal cancer).ConclusionsWomen with MetS were at increased risk of colon and rectal cancer. Clinical and public health strategies should be considered for primary CRC prevention with an emphasis on improving women’s metabolic health across all BMI groups.