Cigarette smoking,alcohol use,and gallstone risk in Japanese men

BACKGROUND/AIM: Results of epidemiological studies concerning the association between smoking and alcohol use and gallstone risk are inconsistent. We examined the relation of smoking and alcohol use to gallstone disease in Japanese men. METHODS: We investigated 174 cases having gallstones as determined by ultrasonography, 104 cases of postcholecystectomy state, and 6,906 controls having a normal gallbladder in the consecutive series of 7,637 men aged 48-59 years receiving a retirement health examination at four hospitals of the Self-Defense Forces from 1986 to 1994. Fifty men had been aware of having gallstones. Known gallstones and postcholecystectomy state were combined as known gallstone disease. Smoking and drinking habits were ascertained by a self-administered questionnaire. Statistical adjustment was made for body mass index, glucose tolerance status, Self-Defense Forces rank, hospital, and either cigarette smoking or alcohol use. RESULTS: Cigarette smoking was not measurably associated with either prevalent gallstones or postcholecystectomy state, nor with either newly diagnosed gallstones or known gallstone disease. Alcohol use was related to a significant decrease in the prevalence odds of both gallstones and postcholecystectomy state, and the decrease was slightly more profound for known gallstone disease. CONCLUSIONS: Cigarette smoking is probably unrelated to the gallstone risk, and alcohol consumption seems to confer protection against gallstone formation.     

Gallstones,serum lipids,and glucose tolerance among male officials of Self-Defense Forces in Japan

The relationships of gallstones and the postcholecystectomy state with serum total cholesterol, serum triglycerides, glucose tolerance, and obesity were examined in male officials of the Self-Defense Forces in northern Kyushu, Japan. The study population had rather low rates of gallstones (2%) and prior cholecystectomy (3%). A strong relationship between obesity and gallstones was confirmed. Glucose intolerance was associated with the risk of gallstones independent of obesity. No relation between gallstones and either serum total cholesterol or triglycerides after adjustment for obesity and glucose tolerance was evident. However, the serum concentration of total cholesterol among men having had a cholecystectomy was less than that of those without gallstones.     

Gallstones,gallbladder disease,and pancreatitis: cross-sectional and 2-year data from the Swedish Obese Subjects (SOS) and SOS reference studies

OBJECTIVES: Obesity and weight loss have been associated with gallstone disease. There is also an association between gallstones and pancreatitis. We investigated cross-sectional relationships between body mass index (BMI), body fat distribution, and prevalence of gallstones, gallbladder disease, and pancreatitis in men and women. Furthermore, 2-yr incidences of these disorders were examined in relation to changes in weight and body fat distribution after surgical and conventional obesity treatment. METHODS: Self-administered questionnaires were used to assess biliary and pancreatic disease. In the cross-sectional investigation, 6328 obese patients and 1135 randomly selected reference individuals were used. Longitudinally, 1422 operated and 1260 conventionally treated patients were examined. RESULTS: Obese subjects had significantly higher prevalence of cholelithiasis, cholecystitis, cholecystectomies, and pancreatitis as compared with the reference population. In women, BMI and waist-hip ratio (WHR) were independently related to an increased biliary disease prevalence. In men, only BMI was independently associated with biliary disease. Compared with conventional treatment, obesity surgery significantly increased the incidence of cholelithiasis, cholecystitis, and cholecystectomies in men. There was no incidence difference among women. In both genders, weight loss, but not change in WHR, was related to an increased incidence of biliary disease. CONCLUSIONS: This study showed an increased prevalence of gallstones, gallbladder disease, and pancreatitis in the obese. Biliary disease was related to BMI and WHR in women, but only to BMI in men. Weight loss, but not change in WHR, increased the risk of biliary disease in both genders.     

The association of differing measures of overweight and obesity with prevalent atherosclerosis: the Dallas Heart Study.

OBJECTIVES: This study sought to evaluate the associations between different measures of obesity and prevalent atherosclerosis in a large population-based cohort. BACKGROUND: Although obesity is associated with cardiovascular mortality, it is unclear whether this relationship is mediated by increased atherosclerotic burden. METHODS: Using data from the Dallas Heart Study, we assessed the association between gender-specific obesity measures (i.e., body mass index [BMI]; waist circumference [WC]; waist-to-hip ratio [WHR]) and prevalent atherosclerosis defined as coronary artery calcium (CAC) score >10 Agatston units measured by electron-beam computed tomography and detectable aortic plaque measured by magnetic resonance imaging. RESULTS: In univariable analyses (n = 2,744), CAC prevalence was significantly greater only in the fifth versus first quintile of BMI, whereas it increased stepwise across quintiles of WC and WHR (p trend <0.001 for each). After multivariable adjustment for standard risk factors, prevalent CAC was more frequent in the fifth versus first quintile of WHR (odds ratio 1.91, 95% confidence interval 1.30 to 2.80), whereas no independent positive association was observed for BMI or WC. Similar results were observed for aortic plaque in both univariable and multivariable-adjusted analyses. The c-statistic for discrimination of prevalent CAC was greater for WHR compared with BMI and WC in women and men (p < 0.001 vs. BMI; p < 0.01 vs. WC). CONCLUSIONS: We discovered that WHR was independently associated with prevalent atherosclerosis and provided better discrimination than either BMI or WC. The associations between obesity measurements and atherosclerosis mirror those observed between obesity and cardiovascular mortality, suggesting that obesity contributes to cardiovascular mortality via increased atherosclerotic burden.     

Sex differences in the relationships between BMI, WHR and incidence of cardiovascular disease: a population-based cohort study

OBJECTIVE: Body mass index (BMI) is associated with increased incidence of cardiovascular disease (CVD). However, the risk could be very different for individuals with the same body mass. The present study explored whether regional fat distribution, as measured by waist-hip ratio (WHR), could modify the impact of BMI on the risk of CVD in men and women. DESIGN: Prospective population-based study. SUBJECTS: A total of 10 369 men and 16 638 women, 45-73 years old, from general population in Malm?, Sweden.Measurements:All subjects were followed over 7 years for the incidences of first-ever cardiac event (CE) and ischemic stroke in relation to BMI category (<25.0, 25.0-29.9, > or =30.0) and WHR. RESULTS: The prevalence of overweight and obesity was 39.4 and 13.0%, respectively. During follow-up, 1280 subjects suffered a CVD event (750 CE, 530 ischemic stroke). The risk of CVD in women increased with increasing levels of WHR, irrespective of BMI category. In men, WHR (per 1 s.d. increase) was associated with increased incidence of CVD in those with normal weight (relative risk (RR)=1.24; 95% CI: 1.13-1.37) after adjustments for confounding factors. However, WHR was not related to CVD in overweight men (RR=1.06; 95%CI: 0.94-1.20) or obese men (RR=1.04; 95%CI: 0.87-1.24). A significant interaction was observed between sex and WHR on the CVD risk. CONCLUSION: The effect of WHR on incidence of CVD is modified by the overall body weight and by gender. WHR adds prognostic information on the cardiovascular risk in women at all levels of BMI, and in men with normal weight.     

男性胆囊胆固醇结石患者血浆脂联素、性激素水平与体脂分布的关系

目的探讨男性胆囊胆固醇结石患者血浆脂联素、性激素水平与体脂分布的关系。方法对30名男性胆囊胆固醇结石患者与30名健康志愿者，分别测定其血浆脂联素、雌二醇（E2）、游离睾酮（FT）、总睾酮（TT）水平，同时监测血压、腰围（WC）、体重指数（BMI）、腰／臀比（WHR），并进行比较。结果（1）结石组血浆FT、TT、脂联素水平较对照组低（P〈0．05），控制BMI、WC、WHR后，结石组脂联素水平仍较对照组低（P〈0．05），而E2值差异无统计学意义（P〉0．05）。结石组WC、WHR、BMI较对照组高（P〈0．01），均具统计学意义。（2）男性胆囊胆固醇结石血浆脂联素水平与WC呈负相关，TT水平与BMI呈负相关，FT水平与BMI、WHR、WC呈负相关，（P〈0．05）。（3）多因素分析提示WHR、TT水平为男性胆囊胆固醇结石发病的危险因素。结论（1）男性胆囊胆固醇结石患者血浆脂联素、TT、FT水平同时降低，TT水平是男性胆囊胆网醇结石发病的危险因素。（2）男性胆囊胆固醇结石患者存在体脂分布异常，雄激素在男性胆囊胆固醇结石病人脂联素水平的降低中似乎未参与调节，脂联素、雄激素水平同时降低可能是由于体脂分布异常所致，体脂分布异常是男性胆囊胆固醇结石发病的危险因素。     

Psychosocial and socio-economic factors in women and their relationship to obesity and regional body fat distribution

BACKGROUND: Abdominal obesity, as well as psychosocial and socio-economic handicaps are risk factors for serious, prevalent diseases. Connections between these variables have been found in men. OBJECTIVE: The principal aim of the present study was to analyse the associations between psychosocial and socioeconomic factors with body mass index (BMI) and the waist-to-hip circumference ratio (WHR) in women. DESIGN: A cohort study of data derived from questionnaires. SUBJECTS: 1137 women from a population sample of 1464 women born in 1956. MEASUREMENTS: Occupational, social and leisure time conditions, smoking and alcohol habits, as well as height, weight and waist and hip circumferences. RESULTS: BMI was associated with teetotalism and negatively to wine drinking. WHR correlated directly with cigarette smoking and negatively with consumption of wine and beer. Both BMI and WHR, adjusted for each other and for smoking and alcohol, showed independent associations with low education, unemployment and problems at work when employed, as well as with little physical activity and much TV-watching. In addition, the WHR showed a negative, independent relationship to housing conditions. CONCLUSION: These observations suggest psychosocial and socio-economic handicaps as well as a low physical activity in abdominally obese women. Similar observations have been made previously in men, but only with the WHR, suggesting an influence of obesity in these relationships in women only. Another interesting gender difference is the positive relationship between being married with BMI in men, as well as being divorced and living alone with the WHR in men only.     

Association between indices of obesity and fasting hyperglycemia in Taiwan

OBJECTIVE: To examine the association of body mass index (BMI), waist-hip ratio (WHR), and waist circumference (WC) with fasting hyperglycemia after adjustment for age, cigarette smoking, and alcohol use. DESIGN: A cross-sectional survey was conducted among individuals visiting four health-screening centers across Taiwan. SUBJECTS: A total of 61 568 subjects (28 734 men and 32 834 women) between 25 and 64 years of age were included. Fasting hyperglycemia was defined as fasting plasma glucose > or =6.1 mmol/l or current diagnosis and use of insulin or hypoglycemic agent. RESULTS: Fasting hyperglycemia was found in 11.0% of men and 8.3% of women. The factors significantly associated with fasting hyperglycemia in men were age, BMI, WHR, and heavy drinking, while for women these factors were age, educational level, BMI, WHR, and heavy smoking. For men, increased risk of fasting hyperglycemia started from age 30 to 34 years, BMI > or =25 kg/m2, and WHR > or =0.82. For women, increased risk of fasting hyperglycemia started from age 35 to 39 years, BMI > or =24 kg/m2, and WHR > or =0.74. WC lost its significance as a predictor of fasting hyperglycemia when WHR included in the model. CONCLUSION: This study found that central obesity and general obesity were both independently associated with increased risk of fasting hyperglycemia in Taiwanese. The relationship between fasting hyperglycemia and central fat accumulation (WHR) begins to appear at levels that would not be regarded as representing obesity in Western populations, suggesting the need to redefine cutoffs for central obesity in this population.     

Relationship of serum leptin concentration and other measures of adiposity with gallbladder disease.

Obesity increases the risk of gallstones, especially in women. Most gallbladder disease studies have used body mass index (BMI) as a measure of overall adiposity, although BMI does not distinguish between fat and lean body mass. Central adiposity may also increase gallstone risk, although this is less well studied. Leptin is a peptide whose serum concentration is highly correlated with total body fat mass. We examined the relationship of gallbladder disease with anthropometric measures and serum leptin concentration in a large, national, population-based study. A total of 13,962 adult participants in the Third National Health and Nutrition Examination Survey underwent gallbladder ultrasonography and anthropometric measurements of BMI, body circumferences, and skinfold thicknesses, and a random subgroup of 5,568 had measures of fasting serum leptin concentrations. Gallstone-associated gallbladder disease was defined as ultrasound-documented gallstones or evidence of cholecystectomy. When controlling for BMI and other gallbladder disease risk factors in multivariate analysis, a test for trend for increasing waist-to-hip circumference ratio and risk of gallbladder disease was statistically significant among women (P =.043) and men (P =.007). BMI remained strongly associated with gallbladder disease among women (P <.001), but was unrelated among men (P =.46). Leptin concentration was associated with gallbladder disease in both sexes (P <.001), but not after controlling for BMI and waist-to-hip circumference in either women (P =.29) or men (P =.65). In conclusion, waist-to-hip circumference ratio was related to gallbladder disease among women and men. Serum leptin concentration was not a better predictor of gallbladder disease than anthropometry.     

Serum ascorbic acid and gallbladder disease prevalence among US adults: the Third National Health and Nutrition Examination Survey (NHANES III)

BACKGROUND: Ascorbic acid-deficient guinea pigs frequently develop gallstones, and ascorbic acid status may also affect the risk of gallbladder disease in humans. To examine the relationship of ascorbic acid, an antioxidant nutrient involved in cholesterol catabolism, to gallbladder disease, we analyzed data collected from a probability sample of US adults. METHODS: Analyses of data from 7042 women and 6088 men enrolled in the Third National Health and Nutrition Examination Survey, 1988-1994, were performed. Multiple logistic regression models stratified by sex were examined, controlling for the effects of age, race, diet, body mass index, and other potential confounders. RESULTS: A total of 761 women (11%) and 235 men (4%) reported a history of clinical gallbladder disease (symptomatic gallstones or cholecystectomy). Of the 9650 participants without a history of clinical gallbladder disease or abdominal pain consistent with gallbladder disease, and with valid abdominal ultrasonography, 408 (8%) of 4863 women and 274 (6%) of 4787 men had asymptomatic gallstones. Serum ascorbic acid level was inversely related to prevalence of clinical and asymptomatic gallbladder disease among women, but not among men. Among women, each SD (27 micromol/L) increase in serum ascorbic acid level was independently associated with a 13% lower prevalence of clinical gallbladder disease (P = .006) and asymptomatic gallstones (P = .048). CONCLUSION: Ascorbic acid, which affects the catabolism of cholesterol to bile acids and, in turn, the development of gallbladder disease in experimental animals, may affect the risk of gallbladder disease among women.     

Obesity and selected co-morbidities in an urban Palestinian population.

OBJECTIVE: To assess the prevalence of obesity and central obesity in an urban Palestinian population and their associations with selected co-morbidities, including diabetes, hypertension and dyslipidaemia. DESIGN: A population-based cross-sectional survey in an urban Palestinian community. SUBJECTS: Men and women aged 30-65 y residing in the urban community, excluding pregnant women. MEASUREMENTS: According to WHO guidelines, obesity for men and women was defined as BMI> or =30 kg x m(-2), while pre-obesity was defined as BMI 25-29.9 kg x m(-2). Central obesity was defined as a waist-to-hip ratio (WHR) of >0.90 in men and >0.85 in women. RESULTS: The prevalence of obesity in this population was high at 41% (49% and 30% in women and men, respectively). Central obesity was more prevalent among men (59% compared to 25% in women). After adjusting for the effects of age, sex, smoking and each other, obesity and central obesity were found to be significantly associated with diabetes, low HDL-cholesterol and elevated triglycerides in separate logistic regression analyses. Central obesity was also significantly associated with hypertension (OR 2.26, 95% CI 1.30-3.91). CONCLUSION: Obesity and central obesity are prevalent in the urban Palestinian population. Their associations with diabetes, hypertension, and dyslipidaemia point to a potential rise in cardiovascular disease (CVD). An understanding of the reasons behind the high prevalence of obesity is essential for its prevention as well as for the prevention of the morbidities to which it may lead.     

Gallstone disease and obesity: a population-based study on abdominal fat distribution and gender differences

Background. Existing evidence suggests the visceral fat is more metabolically active than subcutaneous fat. We aimed to investigate the value of subcutaneous (SAT) and visceral adipose tissue thickness (VAT) for prediction of gallstone disease (GSD) in general population by focus on gender differences and comparison with body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR).Material and methods. In this cross-sectional survey, 1,494 subjects (51.4 % men), aged above 50, randomly selected from Golestan Cohort Study residing in Gonbad City, Iran, underwent anthropometric measurements and abdominal ultrasonography.Results. Prevalence of GSD was 17.8% (95% CI 15.9-19.8). Following adjustment for age and then other potential risk factors, all obesity indices, except for SAT, were associated with GSD in women with the highest odds ratio observed in WHtR (OR 1.52, 95% CI 1.22-1.89). In contrast, WHR was the only associated index in men (OR 1.49, 95% CI 1.08-2.06). The trend of increasing obesity measures across the quartiles with the risk of GSD was significant in subgroups of WHtR and BMI in women and WHR in men. No significant association was found between SAT and GSD in men or women.Conclusions. The best anthropometric indicators of the risk of GSD may differ by gender. In men, WHR might be the only preferred index to estimate risk of GSD. WHtR, WHR, VAT and BMI are associated with GSD risk in women, although WHtR might better explain this risk. SAT is the poor indicator for identifying subjects with GSD in both genders.     

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding for morbid obestity.

Morbid obesity is associated with cholesterol gallstone formation, a risk compounded by rapid weight loss. Laparoscopic gastric banding allows for a measured rate of weight loss, but the subsequent risk for developing gallstones is unknown. METHOD: Twenty-six normal-weight volunteers (body mass index [BMI] less than 30) were compared with 14 morbidly obese patients (BMI greater than 40). Gallbladder volumes were measured ultrasonographically, after fasting and following stimulation with intravenous cholecystokinin-octapeptide (CCK-8) RESULTS: Preoperatively, fasting gallbladder volume and residual volume after CCK stimulation were both two times greater in the obese group (P<0.02 versus controls). Per cent gallbladder emptying was not different. Gallbladder refilling was four times higher in the obese patients (P<0.01). By six weeks postoperatively, the obese patients lost 1.4+/-0.1% body weight per week. Gallbladder emptying decreased 18.4% (80.3+/-3.9% to 65.5+/-6.9%; P<0.05); residual volume rose one-third (not significant), and refilling fell 60.5% (0.43+/-0.09 to 0.26+/-0.04 mL/min; P=0.07). Three patients with weight losses of greater than 1.7% per week developed gallstones; gallbladder emptying fell outside the 95 percentile. By six months, weight loss slowed to 0.5+/-0.1% per week; gallbladder motility improved modestly. No further stones developed. CONCLUSION: Rapid weight loss following laparoscopic gastric banding impairs gallbladder emptying and when pronounced, gallstones form by six weeks postoperatively. The accompanying reduction in gallbladder emptying, increased gallbladder residual volume and decreased refilling promote gallbladder stasis and hence stone formation.     

Association of non-alcoholic fatty liver disease with gallstone disease in the United States hospitalized patient population

BACKGROUND Gallstones and cholecystectomy have been proposed as risk factors for nonalcoholic fatty liver disease(NAFLD). The reason for this may be that both gallstones, as well as NAFLD share several risk factors with regards to their development. Currently, there is a lack of sufficient evidence showing an association between these clinical conditions.AIM To determine whether there is a meaningful association between gallstones and cholecystectomy with NAFLD.METHODS We queried the National Inpatient Sample database from the years 2016 and 2017 using International Classification of Diseases, 10 th revision, Clinical Modification diagnosis codes to identify hospitalizations with a diagnosis of gallstone disease(GSD)(includes calculus of gallbladder without cholecystitis without obstruction and acquired absence of gallbladder) as well as NAFLD(includes simple fatty liver and non-alcoholic steatohepatitis). Odds ratios(ORs) measuring the association between GSD(includes gallstones and cholecystectomy) and NAFLD were calculated using logistic regression after adjusting for confounding variables.RESULTS Out of 14294784 hospitalizations in 2016-2017, 159259 were found to have NAFLD. The prevalence of NAFLD was 3.3% in patients with GSD and 1% in those without. NAFLD was prevalent in 64.3% of women with GSD as compared to 35.7% of men with GSD. After controlling for various confounders associated with NAFLD and GSD, multivariate-adjusted analysis showed that there was an association between NAFLD with gallstones [OR = 6.32; 95% confidence interval(CI): 6.15-6.48] as well as cholecystectomy(OR = 1.97; 95%CI: 1.93-2.01). The association between NAFLD and gallstones was stronger in men(OR = 6.67; 95%CI: 6.42-6.93) than women(OR = 6.05; 95%CI: 5.83-6.27). The association between NAFLD and cholecystectomy was stronger in women(OR = 2.01; 95%CI: 1.96-2.06) than men(OR = 1.85; 95%CI: 1.79-1.92). P value was less than 0.001 for all comparisons.CONCLUSION NAFLD is more prevalent in women with GSD than men. The association between NAFLD and cholecystectomy/gallstones indicates that they may be risk factors for NAFLD.     

Accuracy of anthropometric indicators of obesity to predict cardiovascular risk

CONTEXT: Obesity is associated with various cardiovascular risk factors. The body mass index (BMI) is the standard measure of overweight and obesity. However, more recently, waist to hip ratio (WHR) or waist circumference (WC) as more sensitive measures for visceral obesity have been proposed to be more indicative of cardiovascular risk. OBJECTIVE: This study was performed to test the predictive value of anthropometric parameters for the presence of several cardiovascular risk conditions. DESIGN: The DETECT (Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment) study is a cross-sectional, clinical-epidemiological study. PARTICIPANTS: We studied 5377 unselected subjects (2016 men, 3361 women) without arteriosclerotic disease, aged 20-79 yr, from the DETECT laboratory sample. SETTING: This study was conducted by primary care physicians. INTERVENTION: We measured anthropometric parameters and assessed cardiovascular risk by clinical examination, patient history, and a standardized laboratory program. MAIN OUTCOME MEASURES: We assessed the associations of BMI, WC, hip circumference, WHR, and waist to height ratio (WHtR) to cardiovascular risk by calculating the area under the receiver-operating characteristic curve and adjusted odds ratios for metabolic syndrome, dyslipidemia, and type 2 diabetes. RESULTS: The area under the receiver-operating characteristic curve for WHtR was significantly higher than for all other anthropometric parameters with respect to all risk conditions in women and to dyslipidemia and type 2 diabetes in men. The odds ratios for the presence of risk conditions with 1 sd increase of each anthropometric parameter were highest for WHtR or WC. CONCLUSIONS: There are some indications that WHtR or WC may predict prevalent cardiovascular risk better than BMI or WHR, even though the differences are small.     

Public health significance of upper body adiposity for non-insulin dependent diabetes mellitus in Mexican Americans.

An unfavourable body fat distribution has been associated with an increased prevalence and incidence of non-insulin dependent diabetes mellitus (NIDDM). The potential utility of assessing body fat distribution in diabetes screening, however, has not been assessed. We compared the impact of upper body fat distribution (assessed by the waist-to-hip ratio (WHR)) and body mass index (BMI) and NIDDM using the population attributable risk approach of Levin in 1965 Mexican Americans from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. The population attributable risk percentage (PAR%) was 52.0% for WHR compared to 43.4% for body mass index. After stratification by BMI, women with a high WHR had a PAR% of approximately 50% and men had a PAR% of 28-58%. For any given cutpoint (e.g. the 10th percentile, 20th percentile, etc.) of WHR used to screen for NIDDM, WHR had both a higher sensitivity and a lower false positive rate than the corresponding cutpoint of BMI. To evaluate the relative contribution of WHR in identifying prevalent cases of NIDDM, multiple logistic regression analyses were performed, and the number of subjects identified as being in the top 20% of the risk score distribution was compared using a model that included WHR and a model that included BMI. In men, BMI did not increase the sensitivity in detecting NIDDM subjects once age was accounted for; WHR increased the sensitivity only slightly. In women, sensitivity was enhanced modestly using both measures, although WHR again was the more sensitive method. These data suggest that WHR is a better single screening measure for NIDDM than BMI.     

Relationship between stature, overweight and central obesity in the adult population in S?o Paulo, Brazil.

OBJECTIVE: To test association between overweight, central obesity and stature. DESIGN: Cross-sectional study carried-out between 1990-1991. SUBJECTS: 951 adults (387 male and 564 female) aged 20-64 y, resident in the metropolitan area of S?o Paulo, Brazil. MEASUREMENTS: Anthropometry, blood lipid concentrations (total, high density lipoprotein (HDL) and low density lipoprotein (LDL)-cholesterol, triglycerides (TGs) and blood glucose. Body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference were used to identify overweight (BMI > 25 kg/m2), abdominal obesity (WHR tertile 3 and waist circumference tertile 3), respectively. The subjects were categorised as those of short stature (women < 150 cm, men < 162cm) and those of normal stature (women > or = 150 cm, men > or = 162 cm). RESULTS: Prevalence of short stature was 19.6% and 15.4% in men and women, respectively. Short stature women had higher serum concentrations of total cholesterol, LDL-cholesterol, TGs and glucose than those of normal stature. Among men, this difference was not observed, except for glucose concentrations. Short stature women had high BMI and WHR means in some age categories, compared with those of normal stature. Both overweight and high WHR frequencies were greater in short stature women than in those of normal ones. In multivariate analysis, adjusted by age, income, marital status, education, physical activity and tobacco use, only women group with short stature compared with normal stature had significantly risk of overweight an high WHR. In the same group there was no association with waist circumference. Among the men there was significant opposite association with waist circumference. CONCLUSION: Short stature in women can potentially be an independent risk factor for overweight and high WHR.     

The relationship between asthma symptoms and anthropometric markers of overweight in a Hispanic population.

BACKGROUND: Previous studies have revealed the relationship between asthma and obesity, but the relationship with other markers of overweight and obesity has not yet been investigated. OBJECTIVE: To establish the relationship between asthma symptoms and simple anthropometric indexes (BMI, waist circumference (WC), and waist-to-hip ratio (WHR)) as markers of overweight in an adult Hispanic population. METHODS: The data were obtained from the PRIT (Prevalence of Cardiovascular Risks in General Hospital Workers) 2001 survey. The participants were workers at the Hospital General de México in Mexico City and included 135 men and 398 women aged 43.8 +/- 11.9 and 43.0 +/- 10.5, respectively. Odds ratios for asthma symptoms at different BMI, WC, and WHR cutoff points associated with excessive weight were calculated. The likelihood ratios for having asthma symptoms in participants with various cutoff values of BMI, WC, and WHR also were calculated. RESULTS: Asthma symptoms were not related to anthropometric markers of overweight or obesity in men, while they were associated in women with WC cutoff levels of 80 and 85 cm, and BMI of 25 and 27 kg/m2. No level of WHR was related to asthma symptoms in women. In women, the likelihood ratio for asthma symptoms increased proportionally from WC levels of 73.5 cm up to 86 cm, while this risk increased significantly from BMI levels of 22 up to 29 kg/m2. CONCLUSION: Overweight as assessed by BMI and WC (but not WHR) was related to asthma symptoms in women in the studied population.     

Sleep-disordered breathing and glucose metabolism in hypertensive men: a population-based study

OBJECTIVES: Diabetes mellitus and obstructive sleep apnoea (OSA) are two prevalent medical problems. Both are strongly associated with obesity and hypertension. The aim of this study was to investigate whether the association between OSA and diabetes is entirely dependent on obesity in hypertensive men. DESIGN: A population-based study. SETTING: The municipality of Uppsala, Sweden. Subjects and methods. In 1994, 2668 men aged 40-79 years answered a questionnaire regarding snoring, sleep disturbances and somatic diseases. An age-stratified sample of 116 hypertensive men was selected for a whole-night sleep study. Twenty-five of them had diabetes, defined as reporting regular medical controls for diabetes or having a fasting blood glucose > or =6.1 mmol L(-1). RESULTS: The prevalence of severe OSA, defined as apnoea-hypopnoea index (AHI) > or =20 h(-1) was significantly higher in diabetic patients than in normoglycaemic subjects (36 vs. 14.5%, P < 0.05). The sample was divided into four groups based on the presence or absence of severe OSA and the presence or absence of central obesity, defined as waist-to-hip ratio (WHR) > or =1.0. In a logistic regression model with the non-OSA, WHR <1.0 as the reference group, the adjusted odds ratio (95% confidence interval) for diabetes was 11.8 (2.0-69.8) in the OSA, WHR > or =1.0 group, whilst it was 3.6 (0.9-14.8) in the non-OSA, WHR > or =1.0 group and 5.7 (0.3-112) in the OSA, WHR <1.0 group. In a linear regression model, after adjustment for WHR, there was a significant relationship between variables of sleep-disordered breathing and fasting insulin, glucose and haemoglobin A1c. CONCLUSIONS: We conclude that, in hypertensive men, although obesity is the main risk factor for diabetes, coexistent severe OSA may add to this risk. Sleep breathing disorders, independent of central obesity, may influence plasma insulin and glycaemia.     

Prevalence of overweight and central adiposity is associated with percentage of indigenous ancestry among native Hawaiians.

OBJECTIVE: To assess the relationship of percentage of indigenous ancestry with body mass index (BMI) and waist to hip ratio (WHR) among Native Hawaiians. DESIGN: A cross-sectional, observational study among 567 rural native Hawaiian men and women, aged 30 or older, enrolled between 1993-96. MEASUREMENTS: Ancestry was assessed by self-report, and was verified with a brief genealogical interview. Anthropometric measurements, as well as dietary and physical activity histories were also obtained. RESULTS: Percentage Hawaiian ancestry was significantly associated with increased body mass index (BMI), waist to hip ratio (WHR), and age. The association between percentage Hawaiian ancestry and both anthropometric measures persisted after adjusting for age, leisure time physical activity and total dietary energy intake. CONCLUSION: Obesity and central adiposity were highly prevalent among Hawaiians participating in this study. The association between BMI and WHR with percentage Hawaiian ancestry, unexplained by differences in diet and physical activity, suggests genetic factors play an important role in the high prevalence of obesity observed among Native Hawaiians.