Parent-child obesity and cardiovascular risk factors

Blood pressure, cholesterol, high density lipoprotein cholesterol, and triglycerides were studied in obese children and obese parents selected to participate in a weight treatment program. The relationships between parent and child risk levels, as well as the relationship between child and parent weight and risk factors, were established. Results showed that children's cholesterol and triglycerides were related to parental lipid levels, independent of weight. Children's blood pressure readings were strongly related to their weight, but not to parental blood pressure. High density lipoprotein cholesterol levels were negatively related to weight in both child and parent female populations, and weakly positively related to weight for male children. Implications of these risk factor patterns for intervention are discussed.     

BMI,waist circumference,and clustering of cardiovascular risk factors in Japanese adults

Objective  

To examine whether the association between waist circumference (WC) and clustering of cardiovascular risk factors varies with obesity (BMI) status.     

老年肥胖与心血管病主要危险因素聚集的关系

目的 探讨老年人肥胖与发生心血管疾病主要危险因素聚集之间的相关关系.方法 采用横断面调查546名60～90岁的老年人,用描述性统计方法、logistic回归和ROC工作曲线法进行相关分析. 结果 (1)四种危险因素及危险因素聚集的检出率随着BMI、腰围(WC)水平的上升而增加,危险因素聚集检出率为59.5%,其中男性组为52.5%,女性组为65.7%.(2)随着BMI和(或)WC水平的上升,老年男性发生危险因素聚集风险的增长速度要高于女性,其中男性最高水平组OR值为13.579,女性组为2.876.(3)男性BMI和WC均与危险因素聚集存在独立的相关性(P<0.05),logistic回归系数分别为bBMI=0.196,bWC=0.074;女性只有WC与危险因素聚集存在独立的相关性(P<0.05),logistic回归系数为bWC=0.060,而BMI与危险因素聚集不存在独立的相关性(P=0.537).(4)男性的BMI和WC组合公式(CE)为CEBMI+WC=0.726×BMI+0.274×WC,最佳截断值为41.59,其灵敏度和特异度分别为0.785和0.598. 结论 四种主要的心血管病危险因素经常伴随着肥胖出现,BMI和WC对于心血管疾病的一级预防具有重要意义,两者的组合公式可用于预测个体的心血管疾病危险因素聚集风险.     

Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis

OBJECTIVE: To determine which simple index of overweight and obesity is the best discriminator of cardiovascular risk factors. STUDY DESIGN AND SETTING: This is a meta-analysis of published literature. MEDLINE was searched. Studies that used receiver-operating characteristics (ROC) curve analysis and published area under the ROC curves (AUC) for overweight and obesity indices with hypertension, type-2 diabetes, and/or dyslipidemia were included. The AUC for each of the four indices, with each risk factor, was pooled using a random-effects model; male and female data were analyzed separately. RESULTS: Ten studies met the inclusion criteria. Body mass index (BMI) was the poorest discriminator for cardiovascular risk factors. Waist-to-height ratio (WHtR) was the best discriminator for hypertension, diabetes, and dyslipidemia in both sexes; its pooled AUC (95% confidence intervals) ranged from 0.67 (0.64, 0.69) to 0.73 (0.70, 0.75) and from 0.68 (0.63, 0.72) to 0.76 (0.70, 0.81) in males and females, respectively. CONCLUSION: Statistical evidence supports the superiority of measures of centralized obesity, especially WHtR, over BMI, for detecting cardiovascular risk factors in both men and women.     

正常体质指数性肥胖与心血管危险因素的研究

目的探讨体质指数（BMI）正常但体脂肪含量（BF％）偏高的正常体质指数性肥胖（NWO）与心血管危险因素之间的关系。方法采用横断面研究的方法对健康体检者940名,选取BMI介于18．5～25kg／m^2者407名。利用生物电阻抗（BIA）原理进行BF％测定,按BF％≥25％（男）或BF％≥35％（女）定义为NWO组,BF％〈25％（男）或BF％〈35％（女）者为对照组。两组心血管危险因素水平及检出率的比较采用独立样本t检验和χ^2检验。Logistic回归分析NWO组发生各心血管危险因素的危险度（OR）。结果男性、女性NWO检出率分别为13．13％、14．91％。随年龄增长NWO检出率有增高趋势（趋势χ^2=6．90,P〈0．05）。NWO组收缩压、舒张压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇及尿酸水平均高于对照组（t分别为2．97、2．44、2．54、5．09、2．71和3．91,P〈0．05）,高密度脂蛋白胆固醇水平低于对照组（t=-3．90,P〈0．05）。高血压、高血糖、高三酰甘油、低高密度脂蛋白胆固醇、血脂异常及高尿酸的检出率NWO组均高于对照组（χ^2分别为6．76、5．58、14．50、11．97、10．97和8．76,P〈0．05）。NWO组高血压、高血糖、高血脂和高尿酸的发病风险分别是对照组的2．186、2．120、2,088和4．175倍。校正了年龄和性别因素,NWO组高尿酸的发病风险降低为对照组的3．491倍。结论NWO与心血管危险因素相关,是具有高心血管疾病危险的群体。     

广西南宁市壮族成年人心血管疾病危险因素的流行与聚集情况分析

目的 分析广西南宁市壮族居民心血管疾病（CVD）危险因素流行及聚集情况。方法 2017年利用国家重点研发计划项目中广西壮族自治区项目点资料对南宁市20-70岁1837名城乡壮族居民进行调查,包括问卷调查、体格检查及实验室检查,采用SPSS 19.0进行t检验、〖XC小五号.EPS;P〗检验和多分类logistic 回归分析。结果 广西南宁市壮族居民高血压、血脂异常、糖尿病、超重肥胖和饮酒的流行率分别为49.63%、49.31%、8.22%、43.14%和20.66%。在老年人、文化水平较低的壮族成年人以及城市居民中,心血管疾病危险因素聚集的比例更高（〖XC小五号.EPS;P〗=120.430、32.460、12.429, 均P<0.05）。具有≥1和≥2种心血管疾病危险因素聚集的发生率为82.87％和54.70％。Logistic回归分析结果显示:65岁以上居民1种、≥2种CVD危险因素聚集风险分别是小于34岁居民的2.366倍（95%CI:1.104~5.069）和5.992倍（95%CI: 2.956~12.146）;文化程度越高,≥2种CVD危险因素聚集的风险越低;农村居民1种、≥2种CVD危险因素聚集风险低于城市居民。结论 广西南宁市壮族居民心血管疾病危险因素的流行处于较高水平,危险因素聚集水平较高,应该采取有效措施控制心血管疾病危险因素,降低壮族居民心血管疾病的风险。     

Prehypertension and clustering of cardiovascular risk factors among adults in suburban Beijing, China

Background

Prehypertension is common in China and is associated with an increased risk of cardiovascular disease. The present study estimated the current prevalence of prehypertension and its association with clustering of other modifiable cardiovascular risk factors (CRFs) among adults in suburban Beijing.

Methods

A cross-sectional survey of a representative sample of 19 003 suburban adults aged 18 to 76 years was carried out in 2007. Questionnaire data and information on blood pressure, anthropometric characteristics, and laboratory measurements were collected.

Results

The age-standardized prevalence of prehypertension was 35.7% (38.2% in men and 31.8% in women) among adults in suburban Beijing. The prevalence of overweight/obesity, diabetes, dyslipidemia, and physical inactivity was higher in participants with prehypertension (26.7%, 4.8%, 34.3%, and 60.4%, respectively) as compared with normotensive participants (15.9%, 2.7%, 20.5%, and 29.1%, respectively), and in participants with hypertension as compared with those with prehypertension. Overall, 85.3%, 49.8%, and 17.8% of prehypertensive men had 1 or more, 2 or more, and 3 or more CRFs (overweight/obesity, diabetes, dyslipidemia, current smoking, and physical inactivity). These proportions were higher than those in normotensive men (81.5%, 45.1%, and 13.4%) and lower than those in men with hypertension (91.7%, 56.4%, 19.2%). Similar results were found when women with prehypertension were compared with women who were normotensive or hypertensive.

Conclusions

A high prevalence of prehypertension and clustering of other modifiable CRFs are common among prehypertensive adults in suburban Beijing. More-effective population-based lifestyle modifications are required to prevent progression to hypertension and reduce the increasing burden of cardiovascular disease in China.Key words: prehypertension, cardiovascular, risk factor, clustering, suburban     

Obesity,diabetes and associated cardiovascular risk factors among Torres Strait Islander people

OBJECTIVE: To describe the lifestyle-related chronic disease and risk factor prevalence among Torres Strait Islander people of the Torres Strait and Northern Peninsula Area Health Service District and to compare this information with that available for the general Australian population. METHODS: Voluntary community-based screening for persons aged 15 years and older, including oral glucose tolerance test, anthropometry, health questionnaire, measurement of lipids and lipoprotein levels, blood pressure and urinary albumin to creatinine ratio. RESULTS: Nine communities participated in screening between 1993 and 1997. Five hundred and ninety-two participants (286 male and 306 female) identified as Torres Strait Islander. There were high prevalences of overweight (30%), obesity (51%), abdominal obesity (70%), diabetes (26%), hypercholesterolaemia (33%), albuminuria (28%), hypertension (32%) and tobacco smoking (45%). Only 8.5% of men and 6.5% of women were free of any cardiovascular risk factors (abdominal obesity, hypercholesterolaemia, hypertension, dyslipidaemia, smoking, diabetes, albuminuria). Comparisons of this information for Torres Strait Islander people with results from the AusDiab survey show rates of obesity three times higher and diabetes six times higher than for other Australians. CONCLUSIONS: There is a very high prevalence of preventable chronic disease and associated risk factors among Torres Strait Islander people of the Torres Strait and Northern Peninsula Area. Implications: Effective interventions to prevent and manage obesity, diabetes and associated cardiovascular risk factors are essential if the health of the Torres Strait Islander people is to improve. Such interventions could inform initiatives to stem the burgeoning epidemic of obesity and diabetes among all Australians.     

云南省农村居民心血管病危险因素聚集性及其影响因素的研究

应用云南省农村居民的现场调查资料,对心血管疾病危险因素的聚集性及社会经济影响因素进行分析. 1.对象与方法:调查对象为云南省2个县18岁及以上的农村居民.在获得被调查者的知情同意后,通过现场问卷调查和体检进行资料的收集.调查于2009-2010年进行.     

Relation of obesity to clustering of cardiovascular disease risk factors in children and young adults. The Bogalusa Heart Study

The relation of obesity to clustering of systolic blood pressure, fasting insulin, and ratio of low and very low density lipoprotein cholesterol to high density lipoprotein cholesterol [LDL-C + VLDL-C)/HDL-C) was investigated in 3,503 subjects aged 5-24 years in Bogalusa, Louisiana, from September 1981 to September 1983. Risk ratios (RR) were calculated as the number of subjects with risk factor variables in the upper tertile divided by the expected number. The variables showed strong clustering (RR = 3.1); however, after adjusting for obesity, clustering of systolic pressure, (LDL-C + VLDL-C)/HDL-C, and insulin was reduced (RR = 1.3). Lean subjects (lower tertile of obesity) showed less clustering than expected (RR = 0.4), while more obese subjects (upper tertile of obesity) had greater clustering than expected (RR = 3.1). Furthermore, trunk fat deposition (subscapular skinfold) had a greater impact on clustering at high levels than limb fat deposition (triceps skinfold). Since obesity is related to clustering of risk factor variables in children and young adults, the prevention of the onset of obesity in early life may be important to reducing the risk of coronary heart disease in later life.     

中国2型糖尿病防治指南(2017年版)

  目的  了解广东省中山市居民血尿酸（SUA）水平与糖尿病患病的关系,为糖尿病的预防控制提供参考依据。  方法  采用以社区为基础1 : 2匹配的病例对照研究方法,将2016年8 — 12月中山市24个镇区成人常住居民慢性病及其危险因素调查中确诊的721例糖尿病患者作为病例组及按病例组同性别、年龄（ ± 2岁）匹配同期调查中1 442名非糖尿病者作为对照组进行问卷调查、体格检查和实验室检测;采用多因素条件logistic回归模型分析SUA水平与糖尿病患病的关系。  结果  病例组糖尿病患者SUA水平为（376.80 ± 106.10）μmol/L,高于对照组非糖尿病者SUA水平的（283.40 ± 75.02）μmol/L（t = – 23.64,P < 0.001）;按SUA水平进行四分位数分组,SUA水平最低四分位数、第二四分位数、第三四分位数和最高四分位数者糖尿病的患病率分别为15.02 %、18.86 %、32.40 % 和67.60 %,糖尿病患病率随SUA水平的升高呈上升趋势（χ²_趋势 = 8.116,P < 0.001);在校正了性别、年龄、腰围、臀围、体质指数（BMI）、收缩压（SBP）、舒张压（DBP）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）等混杂因素后,多因素条件logistic回归分析结果显示,SUA水平第二四分位数和第三四分位数者糖尿病患病风险分别为最低四分位数者的3.101倍（OR = 3.101,95 % CI = 2.150～4.471）和16.236倍（OR = 16.236,95 % CI = 10.659～24.731）。  结论  SUA水平升高可增加中山市居民糖尿病的患病风险。     

重庆社区居民中心性肥胖患病率及其影响因素分析

目的了解重庆社区居民中心性肥胖患病情况及相关因素,为干预政策的制定提供依据。方法采用多阶段随机整群抽样的方法对重庆市沙坪坝区56233名居民进行问卷调查,计算中心性肥胖患病率情况,应用Logistic回归模型进行危险因素分析。结果中心性肥胖患病率为29．66％,其中男性为31．20％,女性为28．20％,差异有统计学意义（P〈0．05）;多因素Logistic回归分析显示,年龄（OR=1．099）、性别（OR：1．094）、婚姻（OR=1．033）、喜甜食（OR=1．255）、喜咸食（OR=1．054）、常吃油炸食物（OR=1．072）、BMI（OR=2．166）为中心性肥胖的危险因素,文化程度（OR=0．959）、常吃过热食物（OR=0．758）、经常参加体育锻炼（OR=0．408）为中心性肥胖的保护因素。结论重庆市居民中心性肥胖患病率较高,应尽快出台控制肥胖的政策和措施,对居民进行防治知识的健康教育。     

Obesity and undernutrition and cardiovascular risk factors in rural and urban Gambian communities

OBJECTIVES: This study documented the prevalence of and cardiovascular risk factors associated with obesity and undernutrition in the Gambia. METHODS: Adults (> or =15 years; N = 5373) from rural and urban areas completed a questionnaire; their height, weight, and waist and hip circumferences were measured, and their cardiovascular risk factors were assessed. RESULTS: Prevalence of undernutrition (body mass index < 18 kg/m(2)) was 18.0%; all strata of society were affected. Prevalence of obesity (body mass index > or =30 kg/m(2)) was 4.0% but was higher (32.6%) among urban women 35 years or older. Cardiovascular risk factors were more prevalent among obese participants. CONCLUSIONS: Undernutrition coexists with obesity, demonstrating a "double burden of disease." Differential interventions should focus on high-risk groups; prevention needs a multisectorial approach.     

Obesity in the elderly and its relationship with cardiovascular risk factors in Taiwan

OBJECTIVES: The obese elderly are at increased risk of mortality, morbidity, and functional disability. In this study, we examined the prevalence of obesity and relationship between various anthropometric indices (AI) and cardiovascular disease (CVD) risk factors in the elderly. RESEARCH METHODS AND PROCEDURES: A stratified multistage clustered sampling scheme was used in the Elderly Nutrition and Health Survey in Taiwan during 1999 to 2000. 2432 non-institutionalized subjects (age, 72.8+/-9.4 years; BMI, 23.6+/-6.4 kg/m2) were recruited. The receiver operating characteristic analysis was used to compare predictive validity of CVD risk factors among various AI, including BMI, waist circumference (WC), and waist-to-hip ratio (WHR). RESULTS: The prevalence of obesity was 29.0% in men and 36.8% in women by obesity criteria for Asians (BMI>or=25 kg/m2) and 13.3% in men and 21.0% in women by the Taiwanese definition (BMI>or=27 kg/m2). Odds ratios of acquiring various CVD risk factors increased significantly with increment of WC, WHR, and BMI. The areas under the curve predicting metabolic syndrome were all <0.8. The cut-off values of WC corresponding to the highest sensitivity and the highest specificity in predicting various CVD risk factors were 86.2-88.0 cm in men and 82.0-84.0 cm in women, respectively. DISCUSSION: Obesity was prevalent in the Taiwanese elderly. WC was related to CVD risk factors to a greater extent than BMI and WHR. However, none of them alone was a good screening tool for CVD risk factors. Therefore, how to apply AI prudently to screen elderly for CVD risk factors needs further research.     

Obesity and cardiovascular disease risk factors in firefighters: a prospective cohort study

OBJECTIVE: Obesity, despite being a significant determinant of fitness for duty, is reaching epidemic levels in the workplace. Firefighters' fitness is important to their health and to public safety. RESEARCH METHODS AND PROCEDURES: We examined the distribution of BMI and its association with major cardiovascular disease (CVD) risk factors in Massachusetts firefighters who underwent baseline (1996) and annual medical examinations through a statewide medical surveillance program over 5 years of follow-up. We also evaluated firefighters' weight change over time. RESULTS: The mean BMI among 332 firefighters increased from 29 at baseline to 30 at the follow-up examination (2001), and the prevalence of obesity increased from 35% to 40%, respectively (p < 0.0001). In addition, the proportion of firefighters with extreme obesity increased 4-fold at follow-up (from 0.6% to 2.4%, p < 0.0001). Obese firefighters were more likely to have hypertension (p = 0.03) and low high-density lipoprotein-cholesterol (p = 0.01) at follow-up. Firefighters with extreme obesity had an average of 2.1 CVD risk factors (excluding obesity) in contrast to 1.5 CVD risk factors for normal-weight firefighters (p = 0.02). Finally, on average, normal-weight firefighters gained 1.1 pounds, whereas firefighters with BMI > or = 35 gained 1.9 pounds per year of active duty over 5 years of follow-up. DISCUSSION: Obesity is a major concern among firefighters and shows worsening trends over time. Periodic medical evaluations coupled with exercise and dietary guidelines are needed to address this problem, which threatens firefighters' health and may jeopardize public safety.     

父母超重肥胖与儿童代谢指标异常聚集性的关系

目的 探讨父母超重肥胖与儿童代谢指标异常聚集性的关系,为心血管病危险因素的防控提供科学依据。方法 2017年11月-2018年1月采用方便整群抽样的方法,以山东省淄博市桓台县某所小学作为调查点,将身体测量、问卷调查和血生化检测均完整的1 280名6~11岁儿童作为研究对象。分析父母超重肥胖与儿童代谢指标异常及其聚集性的关系。结果 父母一方和双方均超重肥胖的检出率分别为55.6%和19.8%。儿童代谢指标异常(腹型肥胖、血压偏高)及其聚集性(2项和≥3项代谢指标异常)检出率在父母不同体重状态组间差异有统计学意义(P<0.05或<0.001)。与父母均体重正常的儿童相比,父母一方超重肥胖儿童存在腹型肥胖(OR＝2.00)和1项代谢指标异常(OR＝1.47)的危险性较高(P<0.05或<0.001),而双方均超重肥胖儿童存在腹型肥胖(OR＝3.08)、血压偏高(OR＝1.74)和代谢异常指标聚集(OR＝1.64~4.60)的危险性更高(P<0.05或<0.001)。结论 父母超重肥胖与儿童腹型肥胖、血压偏高和代谢指标异常聚集性存在关联。这提示应该对有父母超重肥胖史的高危儿童进行重点干预。