Obesity, body mass index, waist circumference and mortality

Obesity belongs to civilization diseases with its incidence and prevalence increasing all over the world. Complications of obesity represent a serious socioeconomic problem. Obesity is a part of the metabolic syndrome and an independent mortality risk factor in all age categories, however, this relation is twice as strong in individuals under fifty years of age. Slight overweight in old age is associated with reduced total mortality risk. Simple evaluation of obesity via calculation of body mass index and measurement of waist circumference can be carried out in every medical consulting room.     

老年人体质量指数、腰围与血压关系的探讨

目的 探讨老年人血压与体质量指数（BMI）和腰围（WC）的关系。方法 入选2010年1月至2014年12月期间在解放军总医院门诊部干部诊疗科接受查体的离退休老干部449例,按BMI将研究对象分为BMI正常组、超重组和肥胖组。按WC将研究对象分为WC正常组和腹型肥胖组,对其基本情况和血压情况进行记录分析。结果 在超重组、肥胖组和腹型肥胖组中,男性和女性间检出率差异无统计学意义（P＞0.05）。超重者和肥胖者的24h平均收缩压（SBP24h）、24h平均舒张压（DBP24h）以及高血压检出率均显著高于正常BMI者;腹型肥胖者上述指标也显著高于WC正常者。相关分析证实BMI和WC与SBP24h、DBP24h均显著正相关。结论 本研究证实老年人群中BMI和WC与血压的正相关性,提示体质量管理在高血压防治中的重要性。     

Association between selected trace elements and body mass index and waist circumference: A cross sectional study

BackgroundThe prevalence of obesity has increased worldwide. Abnormal plasma level of some trace elements may be associated with obesity. The present study was designed to compare the plasma level of zinc, phosphate, calcium and magnesium with the degree of body mass index and waist circumference.Material and methodsIn this cross sectional study 149 persons (20–60 years old) from March 2014 till April 2017 were included. Definition of central obesity was waist circumference (WC)≥ 102 cm and ≥88 cm in men and women, respectively. Also BMI categorized to: normal weight: 18.50–24.99, overweight: 25.00–29.99 and obese: ≥30 kg/m2 respectively.Mg, Ca, P and Zinc in plasma was checked after12 h fasting in each persons. Comparison between the level of Mg, P, Ca and Zinc by three categories of BMI or waist circumference performed. The data were analyzed by independent T-test and one-way ANOVA. Scheffe method was used to determine post-hoc pair-wise comparisons. The relationship between BMI and concentration of elements was detected by linear correlation and Cubic model. A p ≤ 0.05 were considered statistically significant. Statistical analyses were executed by SPSS version 20.ResultsIn this study, 32.2% male and remainder female, mean age of 42.26 ± 13.03 were participated. 40.9% were normal and 59.1% obese base on waist circumference. Also 24.8% normal,44.3% overweight and remainder was obese according to BMI. Obese subjects base on waist circumference had significantly lower serum Zinc(pvalue:0.002), Ca (pvalue:0.0001)and Mg(pvalue:0.042) concentration. Whereas, P concentration was significantly higher in obese cases in comparison with normal subjects(pvalue:0.012). Also normal cases had significantly higher serum Zinc (pvalue: 0.0001), Ca (pvalue:0.0001), and Mg(pvalue:0.006) concentration compared to overweight and obese subjects according to BMI categorizes.ConclusionInverse correlation present between plasma zinc, calcium and magnesium level and BMI and waist circumference, but positive correlation seen between P level and waist circumference. Further studies are needed to evaluate the effect of dietary or supplemental interventions on obesity and central obesity.     

Larger body mass index and waist circumference are associated with lower mortality in Chinese long-term care facility residents

OBJECTIVES: To investigate the association between body mass index (BMI) and waist circumference (WC) and all‐cause mortality of Chinese residents in long‐term care facilities in Taiwan. DESIGN: Prospective cohort study. SETTING: Eight long‐term care facilities in Taiwan. PARTICIPANTS: Three hundred fifty‐four residents aged 60 and older (median 78.4, range 60–101; 156 men, 198 women) were recruited during the study period. MEASUREMENTS: Anthropometrics and metabolic parameters were measured at baseline. Mean BMI was 21.7±4.2 kg/m² (range 11.6–35.3 kg/m², and mean WC was 82.4±10.9 cm (range 55.0–124.0 cm). Mortality data were from the Department of Health in Taiwan. RESULTS: There were 219 deaths during the 5 years of follow‐up. After adjusting for age, sex, albumin, Karnofsky performance status scale, hypertension, and diabetes mellitus, subjects in the highest quartile of BMI (27.3± 2.8 kg/m²) and WC (96.7±7.4 cm) had a significantly lower mortality rate than did subjects in the lowest quartile (BMI, 16.7±1.7 kg/m²; WC, 69.6±4.2 cm). After further stratification according to central obesity status, the subjects in the two highest BMI quartiles had a lower mortality rate than those in the lowest BMI quartile but only in the central obesity group (≥90 cm in men or ≥80 cm in women). The adjusted relative risk for all‐cause mortality in the highest versus lowest BMI quartile was 0.17 (95% confidence interval=0.05–0.57). CONCLUSION: BMI and WC were negative predictors for all‐cause mortality in older Chinese adults living in long‐term care facilities. Participants with higher WC and BMI had lower all‐cause mortality.     

Metabolic risks in individuals with normal body mass index and normal waist circumference.

BACKGROUND: Risk of cardiovascular diseases increases in Asian adults within the normal limits of body mass index and waist circumference. OBJECTIVE: To determine a point of body mass index and waist circumference above which the chances of having cardiovascular risk factors increased. METHODS: Data on anthropometric indices, blood pressure and biochemical measures were collected in a cross-sectional study of 3447 participants (1781 males and 1666 females) with normal body mass index (19 to <25 kg/m for both sexes) and normal waist circumference (<102 cm for men and <88 cm for women). Metabolic abnormalities were defined on the basis of the standard published criteria. RESULTS: Individuals at the highest category of body mass index (24 to <25 kg/m) had significantly higher odds for having metabolic risk factors (odds ratios ranging from 1.3 to 1.6 for men and 1.36 to 2.0 for women for different risk factors) compared with those at first category (19 to <20 kg/m). Furthermore, individuals at the top category of waist circumference (95 to <102 cm for men and 85-88 cm for women) had significantly higher chances of having metabolic abnormalities (odds ratios ranging from 2.6 to 4.5 for men and 2.1 to 2.6 for women for different risk factors) compared with those in the first category (62 to <70 cm for men and 60 to <65 cm for women) in both sexes. CONCLUSION: We concluded that the cut-off points of body mass index and waist circumference suggested by the World Health Organization are inappropriate for the Tehranian urban population.     

湖北地区居民腰围和体质量指数与高血压的相关性研究

目的探讨湖北地区居民腰围及体质量指数(BMI)与高血压之间的相关性。方法采用分层多阶段随机抽样的方法,于2013年1月至2014年1月对湖北地区5个城区及5个乡村年龄15岁居民20 539例进行调查研究。通过体格检查、问卷调查的方式收集调查对象的个人基本情况及腰围等资料。结果男性及女性在高血压发病情况上差异有统计学意义(P0.05)。≥60岁3个不同年龄组(60~69,70~79,80~89岁)研究对象在高血压发病率上随年龄增加而逐渐升高,且差异有统计学意义(P0.05)。高血压组超重、肥胖、腹型肥胖、超重伴腹型肥胖发生率均高于非高血压组。两组人群在超重、肥胖、腹型肥胖、超重伴腹型肥胖发生率上差异有统计学意义(P0.05)。收缩压、年龄、基础代谢、身体脂肪率、内脏脂肪指数、性别均为BMI的危险因素;对于男性,舒张压、基础代谢、身体脂肪率、内脏脂肪指数为中心性肥胖的危险因素,年龄为中心性肥胖的保护因素;对于女性,舒张压、年龄、基础代谢、身体脂肪率、内脏脂肪指数为中心性肥胖的危险因素。结论湖北地区居民超重及肥胖形势严峻,腰围及BMI与高血压关系密切。     

沧州农村地区老年人群体质量指数和腰围与高血压的相关性研究

目的探讨沧州农村地区老年人群体质量指数和腰围与高血压患病率的关系。方法按照整体随机抽样方法,对沧州某农村地区年龄60⁸9岁1560例居民进行问卷调查、医学体检,根据高血压诊断标准分为高血压组868例和非高血压组692例。以不同体质量指数及腰围分层,比较高血压患病率及相关危险因素。结果高血压组超重(33.6%vs 10.8%)、肥胖(38.8%vs 9.7%)、腹型肥胖(36.6%vs 19.4%)、超重伴腹型肥胖(23.3%vs6.1%)检出率明显高于非高血压组(P<0.01)。而腰围异常老年人群患高血压风险度是腰围正常者的2.41倍(95%CI:1.90689岁1560例居民进行问卷调查、医学体检,根据高血压诊断标准分为高血压组868例和非高血压组692例。以不同体质量指数及腰围分层,比较高血压患病率及相关危险因素。结果高血压组超重(33.6%vs 10.8%)、肥胖(38.8%vs 9.7%)、腹型肥胖(36.6%vs 19.4%)、超重伴腹型肥胖(23.3%vs6.1%)检出率明显高于非高血压组(P<0.01)。而腰围异常老年人群患高血压风险度是腰围正常者的2.41倍(95%CI:1.906³.042,P=0.000)。相关因素分析发现,不良饮食习惯、吸烟、饮酒为该地区老年人群超重或肥胖的高危因素。结论沧州农村地区老年人群超重和肥胖形势严峻,体质量指数和腰围与高血压关系密切,不良生活习惯为其高危因素,改善不良饮食结构是高血压等慢性疾病防治的根本。     

Fifteen-year changes in body mass index and waist circumference in Finnish adults.

BACKGROUND: Obesity is an increasing health problem. Data on long-term obesity trends are most often based on the measurement of body mass index (BMI). Abdominal obesity, assessed by waist circumference may, however, be more closely related to health risks than overall obesity. The aim of this study was to investigate 15-year changes in general and abdominal obesity among adults in Finland, and furthermore, to assess whether obesity trends differ between educational groups. DESIGN: Four cross-sectional population surveys conducted at 5-year intervals between 1987 and 2002. METHODS: Altogether, 9025 men and 9950 women aged 25-64 years participated in these surveys. The weight, height, and waist circumferences of the participants were measured using a standardized protocol. RESULTS: Mean waist circumference increased by 2.7 cm in men and 4.3 cm in women in 15 years. Whereas the distribution of BMI values did not change much, a remarkable shift towards higher waist circumference values was observed in 15 years. In both sexes, mean and high values of waist circumference increased in all educational groups. However, the values remained highest among the subjects with the lowest education. CONCLUSIONS: These results indicate that adverse changes in body shape have taken place from the late 1980s to the early 2000s. Given that one in five Finnish adults is defined as obese based on BMI, there is an even larger group of individuals at risk of obesity-related metabolic disorders because of abdominal obesity, particularly among low-educated individuals.     

The relation between drinking pattern and body mass index and waist and hip circumference

OBJECTIVES: To study the association between alcohol drinking pattern and obesity. DESIGN: Cross-sectional population study with assessment of quantity and frequency of alcohol intake, waist and hip circumference, height, weight, and lifestyle factors including diet. SUBJECTS: In all, 25 325 men and 24 552 women aged 50-65 y from the Diet, Cancer and Health Study, Denmark, 1993-1997 participated in the study. MEASUREMENTS: Drinking frequency, total alcohol intake, body mass index (BMI), and waist and hip circumference. RESULTS: Among men, total alcohol intake was positively associated with high BMI (>/=30 kg/m(2)), large waist circumference (>/=102 cm) and inversely associated with small hip circumference (<100 cm). Among women, the total alcohol was associated with high BMI, large waist (>/=88 cm), and small hips only for the highest intake (28+ drinks/week). The most frequent drinkers had the lowest odds ratios (OR) for being obese. Among men, OR for having a high BMI were 1.39 (95% confidence interval: 1.36-1.64), 1.17 (1.02-1.34), 1.00 (reference), 0.87 (0.77-0.98), and 0.73 (0.65-0.82) for drinking 1-3 days/month, 1 day/week, 2-4 days/week, 5-6 days/week, and 7 days/week, respectively. Similar estimates were found for waist circumference. Corresponding results were found for women. CONCLUSION: For a given level of total alcohol intake, obesity was inversely associated with drinking frequency, whereas the amount of alcohol intake was positively associated with obesity. These results indicate that frequent drinking of small amounts of alcohol is the optimal drinking pattern in this relation.     

Atherogenic index of plasma combined with waist circumference and body mass index to predict metabolic-associated fatty liver disease

BACKGROUNDEarly identification of metabolic-associated fatty liver disease (MAFLD) is urgent. Atherogenic index of plasma (AIP) is a reference predictor of obesity-related diseases, but its predictive value for MAFLD remains unclear. No studies have reported whether its combination with waist circumference (WC) and body mass index (BMI) can improve the predictive performance for MAFLD.AIMTo systematically explore the relationship between AIP and MAFLD and evaluate its predictive value for MAFLD and to pioneer a novel noninvasive predictive model combining AIP, WC, and BMI while validating its predictive performance for MAFLD.METHODSThis cross-sectional study consecutively enrolled 864 participants. Multivariate logistic regression analysis and receiver operating characteristic curve were used to evaluate the relationship between AIP and MAFLD and its predictive power for MAFLD. The novel prediction model A-W-B combining AIP, WC, and BMI to predict MAFLD was established, and internal verification was completed by magnetic resonance imaging diagnosis.RESULTSSubjects with higher AIP exhibited a significantly increased risk of MAFLD, with an odds ratio of 12.420 (6.008-25.675) for AIP after adjusting for various confounding factors. The area under receiver operating characteristic curve of the A-W-B model was 0.833 (0.807-0.858), which was significantly higher than that of AIP, WC, and BMI (all P < 0.05). Subgroup analysis illustrated that the A-W-B model had significantly higher area under receiver operating characteristic curves in female, young and nonobese subgroups (all P < 0.05). The best cutoff values for the A-W-B model to predict MAFLD in males and females were 0.5932 and 0.4105, respectively. Additionally, in the validation set, the area under receiver operating characteristic curve of the A-W-B model to predict MAFLD was 0.862 (0.791-0.916). The A-W-B level was strongly and positively associated with the liver proton density fat fraction (r = 0.630, P < 0.001) and significantly increased with the severity of MAFLD (P < 0.05).CONCLUSIONAIP was strongly and positively associated with the risk of MAFLD and can be a reference predictor for MAFLD. The novel prediction model A-W-B combining AIP, WC, and BMI can significantly improve the predictive ability of MAFLD and provide better services for clinical prediction and screening of MAFLD.     

Association of waist circumference,body mass index and conicity index with cardiovascular risk factors in postmenopausal women

Abstract

In menopause, changes in body fat distribution lead to increasing risk of cardiovascular disease and metabolic disorders. The aim of this study was to assess the association of adiposity using the conicity index (CI), body mass index (BMI) and waist circumference (WC) with cardiovascular risk factors (hypertension, diabetes and dyslipidaemia). The sample of this cross-sectional study was collected from June to October 2010 and 165 consecutive menopausal women who had attended the Health and Treatment Centre and Endocrine Research Centre of Firoozgar Hospital in Tehran, Iran were assessed. Age, weight, height, WC, waist–hip ratio (WHR), CI and fat mass were measured. Systolic and diastolic blood pressure (SBP and DBP), fasting blood glucose, insulin, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) levels were also determined. All statistical analyses were performed by SPSS version 17 (SPSS Inc, Chicago, IL, USA).Results showed that BMI was positively and significantly associated with SBP (r = 0.21; p = 0.009). WC was positively and significantly correlated with SBP (r = 0.26; p = 0.02) and DBP (r = 0.16; p = 0.05). WHR was also significantly and positively associated with SBP (r = 0.29; p = 0.001). Age and WC were associated with CI quartiles at the 0.05 significance level. The correlation of CI quartiles with SBP and weight were at the 0.01 significance level.We showed a significant association of WC with SBP and DBP, and that BMI could be an important determining factor of SBP. For assessing the association between CI and cardiovascular risk factors, future studies with larger sample sizes are recommended.     

体质指数和腰围对高血压患者降压疗效的影响

目的:明确体质指数(BMI)和腰围是否影响高血压患者降压疗效,指导肥胖型高血压患者的治疗。方法:选取原发性高血压住院患者,收集其人口学资料、入院血压及用药情况等基线数据,于出院后2个月随访血压水平,应用Logistic回归分析BMI和腰围对降压疗效的影响。结果:共有338例患者纳入最终分析,随访2个月时总的血压达标率为66.6%,多因素回归分析显示:BMI和腰围都是血压不达标的独立危险因素。在用1类降压药、正常体质量和肥胖的患者中,BMI和腰围不是血压不达标的独立危险因素;在用2~3类降压药和腹型肥胖的患者中,BMI和腰围是血压不达标的独立危险因素;在超质量患者中,仅BMI是血压不达标的独立危险因素。结论:在使用多种降压药及腹型肥胖的患者中,BMI和腰围都是影响高血压患者降压达标的独立危险因素。     

Interrelationships between body mass to waist circumference ratio,body mass index,and total body muscularity in older women

PurposeTo examine the relationships between body mass to waist circumference (BM:W) ratio or body mass index (BMI) and muscularity, 140 overweight (BMI ≥ 25 kg/m² and <30 kg/m²), 265 normal weight (BMI > 18.5 kg/m² and <25 kg/m²) and 26 underweight (BMI ≤ 18.5 kg/m²) Japanese women aged 60–80 years volunteered (overall 431 women).MethodsMuscle thickness was measured by ultrasound at six sites on the anterior and posterior aspects of the body. Total muscle mass (TMM) was estimated from an ultrasound-derived prediction equation. BMI and BM:W ratio were calculated using anthropometrical variables.ResultsWhen the overall sample was used, BMI was positively correlated with the TMM (r = 0.573, p < 0.001) and TMM index (r = 0.659, p < 0.001). BM:W ratio was also positively correlated with the TMM (r = 0.566, p < 0.001) and TMM index (r = 0.400, p < 0.001). In normal weight women, BMI was positively correlated with the TMM (r = 0.460, p < 0.001) and TMM index (r = 0.496, p < 0.001). Similarly, BM:W ratio was positively correlated with the TMM (r = 0.514, p < 0.001) and TMM index (r = 0.318, p < 0.001). In overweight and underweight women, TMM was significantly and positively correlated with BM:W ratio (r = 0.442 and r = 0.715, respectively; p < 0.001), but not BMI (r = 0.077 and r = 0.315). TMM index was also positively correlated with BM:W ratio in both overweight (r = 0.184, p < 0.05) and underweight (r = 0.500, p < 0.01) women. BMI was positively correlated with TMM index (r = 0.230, p < 0.01) and inversely correlated to the percentage of TMM in body mass (r = −0.262, p < 0.01) in overweight women.ConclusionThese results suggest that, compared to BMI, BM:W ratio may provide a simple and potential index for assessing muscularity in Japanese older underweight women. However, in normal and overweight women, BMI and BM:W ratio are both preferred in assessing muscularity.     

体重指数完全代替腰围或腰臀比用于肥胖评估的可行性研究

目的 比较腰围、腰臀比及BMI与代谢相关指标的相关性,探讨BMI本身存在的性别差异及其完全取代腰围或腰臀比的可行性.方法 利用仁济医院健康保健(体检)中心2009年1月至2010年6月客户体检数据库,研究纳入人数2054例,其中男性1322例,女性732例,按不同的性别分析腰围、腰臀比及BMI异常对血脂、血糖及血压的影响,同时比较腰围、腰臀比及BMI用于评估同一群体肥胖发生率的差异.结果 本研究结果显示除了女性BMI正常组和异常组之间总胆固醇水平的差异无统计学意义(P>0.05)外,腰围、腰臀比和BMI异常组的三酰甘油、总胆固醇、高密度脂蛋白、低密度脂蛋白、空腹血糖、糖化血红蛋白及血压水平与正常组相比差异均有统计学意义(P<0.05).在评估同一群体的肥胖发生率时,3种方式的评估结果差异也有统计学意义(P<0.05).男性和女性BMI＜25 kg/m2的群体中,腰围异常的比例分别为19.3%和33.8%.进一步对女性群体的分析发现,如果女性BMI以23.2 kg/m2为切点,对于腹型肥胖筛查的灵敏度和特异度可分别提高到78.1%和87.9%.结论 BMI不能完全取代腰围或腰臀比对腹型肥胖人群的筛查价值.BMI存在明显的性别差异,如果女性BMI以23.2 kg/m2为切点,可以明显提高腹型肥胖筛查的准确度.     

不同体重指数及腰围2型糖尿病患者甲状腺功能的变化探讨

目的 探讨不同体重指数（BMI）及腰围（WC）2型糖尿病（T2DM）患者促甲状腺激素（TSH）和甲状腺激素（TH）水平的变化及肥胖对TSH、TH的影响。方法 收集住院T2DM患者275例,根据BMI不同将其分为正常组（18.5kg/m²≤BMI＜24kg/m²,88例）、超重组（24kg/m²≤BMI＜28kg/m²,90例）和肥胖组（BMI≥28kg/m²,97例）,比较3组患者的血脂水平及甲状腺功能。再根据性别和WC不同将其分为M1组（男性WC<85cm）、M2组（男性WC≥85cm）、F1组（女性WC<80cm）、F2组（女性WC≥80cm）,比较各组间上述指标。相关性分析采用Spearman相关分析,影响因素分析采用多元线性逐步回归分析。结果 与正常组比较,超重组及肥胖组患者的TSH水平明显增加（P<0.05）。F2组TSH水平明显高于F1组和M2组,游离甲状腺素（FT₄）水平低于M2组（P<0.05）。相关性分析结果显示,T2DM患者BMI与TSH呈正相关(r=0.25,P<0.05),TC与游离三碘甲腺原氨酸（FT₃）呈负相关(r=-0.39,P<0.05),BMI、WC与FT₄(r=-0.31,r=-0.29,P<0.05)呈负相关。多元线性逐步回归分析结果显示,BMI是TSH的独立相关因素,WC是FT₄的独立相关因素（P<0.05）。结论 肥胖T2DM患者TSH水平升高,FT₄下降,女性较男性腹型肥胖者变化更加明显。