Application of alternative anthropometric measurements to predict metabolic syndrome

OBJECTIVE:

The association between rarely used anthropometric measurements (e.g., mid-upper arm, forearm, and calf circumference) and metabolic syndrome has not been proven. The aim of this study was to assess whether mid-upper arm, forearm, calf, and waist circumferences, as well as waist/height ratio and waist-to-hip ratio, were associated with metabolic syndrome.

METHODS:

We enrolled 387 subjects (340 women, 47 men) who were admitted to the obesity outpatient department of Istanbul Medeniyet University Goztepe Training and Research Hospital between September 2010 and December 2010. The following measurements were recorded: waist circumference, hip circumference, waist/height ratio, waist-to-hip ratio, mid-upper arm circumference, forearm circumference, calf circumference, and body composition. Fasting blood samples were collected to measure plasma glucose, lipids, uric acid, insulin, and HbA1c.

RESULTS:

The odds ratios for visceral fat (measured via bioelectric impedance), hip circumference, forearm circumference, and waist circumference/hip circumference were 2.19 (95% CI, 1.30-3.71), 1.89 (95% CI, 1.07-3.35), 2.47 (95% CI, 1.24-4.95), and 2.11(95% CI, 1.26-3.53), respectively. The bioelectric impedance-measured body fat percentage correlated with waist circumference only in subjects without metabolic syndrome; the body fat percentage was negatively correlated with waist circumference/hip circumference in the metabolic syndrome group. All measurements except for forearm circumference were equally well correlated with the bioelectric impedance-measured body fat percentages in both groups. Hip circumference was moderately correlated with bioelectric impedance-measured visceral fat in subjects without metabolic syndrome. Muscle mass (measured via bioelectric impedance) was weakly correlated with waist and forearm circumference in subjects with metabolic syndrome and with calf circumference in subjects without metabolic syndrome.

CONCLUSION:

Waist circumference was not linked to metabolic syndrome in obese and overweight subjects; however, forearm circumference, an unconventional but simple and appropriate anthropometric index, was associated with metabolic syndrome and bioelectric impedance-measured visceral fat, hip circumference, and waist-to-hip ratio.     

儿童保健专科护士体格测量数据的可信度研究

目的分析儿童保健专科护士体格测量数据的可信度,确定专科护士测量技术质量控制标准。方法选择重庆医科大学附属儿童医院儿童保健科健康体检的0～12岁儿童为研究对象。1名从事儿童体格测量的副主任护师为测量专家,另1名有1年以上体格测量工作经验的专科护士为对照。分别测量头围、身长（高）、顶臀长（坐高）及胸围4项体格指标1次,记录测量数据。分为〈1岁、～3岁和≥3岁组。计算测量技术误差（TEM）、测量差异均值（MAD）、可信度系数（R）和组间相关系数（ICC）等可信度指标,比较不同体格指标和不同年龄组间可信度的差异。结果 2006年3～10月549名儿童完成了测量,其中〈1岁组224名,～3岁198名,≥3岁127名。①头围、身长（高）、顶臀长（坐高）及胸围的MAD分别为0.17、0.35、0.49和0.64cm;TEM分别为0.16、0.34、0.46及0.59cm,R均为1.00,ICC为0.95～1.00。②各年龄组头围和胸围的MAD差异无统计学意义;〈1岁组和≥3岁组身长（高）的MAD差异有统计学意义;〈1岁、～3岁与≥3岁组顶臀长（坐高）的MAD差异有统计学意义。结论专科护士总体测量技术较好,测量差异均在允许范围内。头围测量的可信度最高,其次是身长（身高）和顶臀长（坐高）,胸围测量不易准确。规范的测量工具、统一的测量方法及专业的测量者是体格测量数据可靠的前提。     

The association of anthropometric measurements and lipid profiles in Turkish hypertensive adults

Background

Few studies have associated anthropometric measurements and lipid profile with hypertension in adult populations and to the best of our knowledge none has been done in Turkey

Objectives

To relate anthropometric derivatives of overweight/obesity with hyperlipidemia status in a group of Turkish hypertensive adults.

Methods

Six hundred forty nine (307 male, 342 female) hypertensive adults aged between 20 and 64 yearswere included in the study.

Results

The mean systolic and diastolic blood pressure (BP) of participants were measured as 147.6±17.2 and 91.4±10.4 mmHg for males and 149.9±16.3 and 91.1±9.4 mmHg for females, respectively. With respect to BMI classification systolic BP was significantly higher in obese males and females, and diastolic BP was only higher in obese females (p<0.05). According to BMIs for lipid profile, high-density lipoprotein-cholesterol (HDL-C), total cholesterol (TC) levels were found to be lower in normal females than other BMI groups. Age and waist circumference (WC) in particular was the most related factor for systolic and diastolic BP in both genders (p<0.05).

Conclusions

This study indicates most hypertensive adults surveyed were overweight and obese. Furthermore, age and WC were the important factors that affects the systolic and diastolic BP in both genders.     

Optimal treatment of replicate measurements in anthropometric studies

Background: Anthropometric studies often include replicates of each measurement to decrease error. The optimal method to combine these measurements is uncertain.

Aim: To identify the optimal method to combine replicate measures for analysis.

Methods: The authors carried out 10?000 Monte Carlo simulations to explore the effect of six approaches to combine replicate measurements in a hypothetical two-group intervention study (n?=?100 per arm) in which the outcome, infant length at age 1 year, was measured two or three times. One group had a true value with a normal distribution N (mean?=?76, SD?=?2.4?cm). Statistical power was estimated to detect a 1?cm difference between the groups, based on a t-test.

Results: Under a realistic scenario with a measurement error distribution N (0, 0.8), highest power was reached by use of the mean and the median of pairwise averages. However, when a portion of the data (≥2%) were contaminated by greater error (e.g. due to data entry), the median of three measurements outperformed all other methods while the mean had the lowest performance.

Conclusion: Obtaining three rather than two measures and using the median of the three replicates is a safe and robust approach to combine participants’ raw data values for use in subsequent analyses.     

抗惊厥药治疗足月新生儿围生期窒息临床疗效的Meta分析

目的总结国内、外抗惊厥药治疗新生儿围生期窒息文献的研究结果,采用Meta分析方法综合评价抗惊厥药治疗新生儿围生期窒息临床疗效,探讨抗惊厥药治疗新生儿围生期窒息的可能性。方法制定原始文献的纳入标准、排除标准及检索策略,检索PubMed、EMBASE、Ovid、Springer和中国期刊全文数据库等,获得抗惊厥药治疗新生儿围生期窒息的相关文献,使用国际Cochrane中心推荐的方法进行文献质量评价,以病死率、严重神经系统发育障碍发生率、新生儿期惊厥发生率和不良反应发生率等作为观察指标,进行定性和定量综合评估。采用RevMan4．22软件进行Meta分析。结果依据纳入和排除标准,共纳入5篇RCT文献,其中文献质量评价1篇为B级,4篇为C级。治疗组4篇文献予苯巴比妥治疗,1篇文献予硫喷妥钠治疗;对照组均予常规治疗。Meta分析结果显示：抗惊厥药治疗组与对照组比较,病死率差异无统计学意义（RR=1．13,95％CI：0．59～2．17）;严重神经系统发育障碍发生率差异无统计学意义（RR：0．61,95％CI：0．30—1．22）;死亡和严重神经系统发育障碍合并发生率差异无统计学意义（RR=0．65,95％CI：0．30～1．41）;新生儿期惊厥发生率差异无统计学意义（RR=0．76,95％CI：0．45～1．31）。结论目前,不建议对存在围生期窒息的足月新生儿给予抗惊厥药作为临床常规治疗。远期疗效仍需多中心和大样本RCT研究来检验抗惊厥药治疗新生儿围生期窒息对降低病死率或严重神经系统发育障碍发生率的效用。     

Design and development of anthropometric device for the standardization of sizes of knee-ankle-foot orthoses

An anthropometric device (AD) was designed and developed to collect data on foot and knee of locomotor disabled people. The aim was to standardize the sizes of knee-ankle-foot orthoses (KAFOs) in a standard modular form so that they can be mass produced to cater for fitting to a large number of locomotor disabled people. The anthropometric data collected on large numbers of locomotor disabled people were processed, with the help of a computer programme, to arrive at standard sizes for three modules, i.e. a foot plate (seven sizes), knee pieces (six sizes) and a lateral upright in a universal size. These modules were produced by plastic injection moulding and compression moulding processes using glass-reinforced polypropylene. KAFOs were assembled and fitted to locomotor disabled people. Feedback obtained was encouraging and this vindicated the concept, design and utility of the AD.     

The association of anthropometric measures and osteoarthritis knee in non-obese subjects: a cross sectional study

OBJECTIVE:

Body mass index (BMI) and knee osteoarthritis have a strong association, but other anthropometric measures lack such associations. To date, no study has evaluated non‐obese knee osteoarthritis to negate the systemic and metabolic effects of obesity. This study examines the validity of the contention that BMI and other anthropometric measures have a significant relationship with knee osteoarthritis.

METHODS:

In total, 180 subjects with a diagnosis of knee osteoarthritis were recruited and classified according to Kellgren‐Lawrence (KL) grades. Body mass index, mid‐upper arm circumference, waist‐hip ratio and triceps‐skinfold thickness were recorded by standard procedures. Osteoarthritis outcome scores (WOMAC) were evaluated.

RESULTS:

(1) In both genders, the BMI was significantly higher for KL grade 4 than for grade 2; triceps‐skinfold thickness was positively correlated with the joint space width of the tibial medial compartment. (2) In males, triceps‐skinfold thickness significantly increased as the KL grades moved from 2 to 4; the significantly higher BMI found in varus aligned knees was positively correlated with WOMAC scores. (3) In females, the waist‐hip ratio was significantly higher for KL grade 4 than for grade 2; a significant correlation was found between BMI and WOMAC scores. The waist‐hip ratio was significantly associated with varus aligned knees and it positively correlated with WOMAC scores and with the joint space width of the tibial medial compartment. The mid‐upper arm circumference demonstrated no correlation with knee osteoarthritis.

CONCLUSION:

This study validates the contention that BMI and other anthropometric measures have a significant association with knee osteoarthritis. Contrary to common belief, the triceps‐skinfold thickness (peripheral fat) in males and the waist‐hip ratio (central fat) in females were more strongly associated with knee osteoarthritis than BMI.     

新生儿听力筛查3270例分析

目的探究本地区新生儿听力筛查模式,获得本地区新生儿听力损失的基本资料。方法选择出生的活产新生儿于出生后72h接受耳声发射(OAE)测试,所有接受初筛的婴儿在出生42d后,再次接受OAE检查,未通过者做听觉脑干诱发电位(ABR)检查。一耳不通过即为不通过,不通过者均经两次以上重复测试。结果 3270名新生儿中2846名 (87．0％)初筛通过;424名未通过,于出生42d后复查,410例通过。OAE测试总的通过率为99．6％。4例接受ABR检查,诊断有不同程度听力损失,发生率为1．2‰。结论本地区采用的新生儿听力筛查模式是可行的。     

Effect of regular training on the anthropometric parameters and urine steroids in childhood

The changes in the anthropometric data and urine steroid metabolites caused by regular training in children in two age groups (11 and 14 years old) were investigated. The skinfolds of older girls participating in regular athletic, swimming or soccer training were thinner compared with age-matched control groups (P < 0.01) and their body mass and constitution were lower (P < 0.05). In the other groups no significant differences were observable in the anthropometric parameters. The trained children in all groups had significantly higher exercise times on the cycle ergometer (P < 0.01, in young boysP < 0.05). The strength of their hands was lower in three trained groups: in younger boys (P < 0.05), in younger girls (P < 0.01) and in older girls (right handP < 0.01, left handP < 0.05). The urinary excretion of androsterone (P < 0.02), 11-ketopregnanetriol (P < 0.01) and pregnenetriol (P < 0.02) was decreased in the older trained girls; pregnenetriol was increased in younger boys (P < 0.05). Urinary excretion of cortisol metabolites was increased in trained boys [in younger boys: tetrahydrocorticosterone (P < 0.05) and 20-hydroxycortisol (P < 0.05); in older boys allotetrahydrocortisol (P < 0.02), cortisol (P < 0.05) and 20-hydroxycortisol (P < 0.05)]. There were no significant differences in the younger girls. In the trained older girls urinary excretion of cortisol metabolites was decreased: tetrahydrocortisone (P < 0.02), allotetrahydrocorticosterone (P < 0.01), tetrahydrocortisol (P < 0.05), -cortolone (P < 0.01), cortisol (P < 0.02), 6-hydroxycortisol (P < 0.01) and 20-hydroxycortisol (P < 0.05). A multivariate analysis of the data from the trained groups and sedentary, age-matched control groups showed that regular training has a significant effect on steroid excretion.     

The associations between sleep disorders and anthropometric measures in adults from three Colombian cities at different altitudes

BackgroundSleep disorders are common but underdiagnosed conditions, which are associated with obesity. In Colombia, the distribution of sleep disorders remains unclear. We aimed to describe the distribution of sleep disorders, according to demographic, geographic and anthropometric characteristics, in adult Colombian populations.MethodsA multicenter study was conducted with 5474 participants recruited from three Colombian cities at different altitudes. A two-stage cluster sampling method was applied. Participants’ mean age was 40.2 years and 53.8% were female. Collected data included demographic information and anthropometric characteristics of adiposity such as body mass index, neck circumference and waist circumference, as well as participants’ scores on five scales used to assess sleep disorders. Disorders included sleepiness, obstructive sleep apnea (OSA), insomnia, poor sleep quality and restless legs syndrome; the scales were the Epworth Sleepiness Scale, Berlin questionnaire, STOP-Bang questionnaire, Pittsburgh Sleep Quality Index and diagnostic criteria for the restless legs syndrome set out by the International Restless Legs Syndrome Study Group.ResultsNearly two-thirds of the population reported at least one sleep disorder according to their results on the five scales (59.6% [95%CI 57.4; 61.81)]. This proportion was similar by sex. Prevalence of overweight was 34.8% and of obesity was 14.4%. Sleep disorders were more frequent among those aged 65 years or more (91.11 [95%CI 86.1; 94.43]), those who were obese (83.71% [95%CI 78.94; 87.56]) and those who resided in the cities at the lowest altitude (72.4% [95%CI 70.2; 74.5]). Waist circumference showed a stronger association with sleep disorders among women than among men.ConclusionsSleep disorders are common in Colombia, irrespective of sex and geographical location. They are associated with obesity. Abdominal obesity could explain the high frequency of sleep disorders among women.We believe that this part of the study will substantially contribute to the understanding of sleep disorders. Further research is needed to identify key factors behind the high prevalence rates of sleep disorders and obesity in Colombia.     

窒息新生儿末梢血糖水平观察

目的探讨窒息对新生儿末梢血糖的影响,并动态监测窒息新生儿血糖水平。方法对76例窒息新生儿血糖在生后1h内进行测定,并与70例正常新生儿进行比较,评价窒息对新生儿血糖水平的影响。结果生后1h窒息组血糖紊乱发生率高于对照组,差异具有统计学意义（χ2=15.134,P〈0.05）,窒息组新生儿血糖水平明显高于对照组（5.09±3.35mmol/LVS3.82±1.31mmol/L,t=2.964,P〈0.05）;重度窒息组发生血糖紊乱的比例高于轻度窒息组,差异具有统计学意义（χ2=8.525,P〈0.05）,重度窒息组新生儿血糖水平明显高于轻度窒息组（6.15±4.33mmol/LVS4.37±2.24mmol/L,t=-2.343,P〈0.05）。经过干预,绝大部分窒息新生儿血糖紊乱可在24h内得以纠正。结论窒息可加重新生儿血糖紊乱,必须加强窒息新生儿血糖的早期监测并给予合理干预,使之尽快恢复正常,减少对神经系统的损伤。     

Influence of anthropometric characteristics on changes in maximal exercise ventilation and breathing pattern during growth in boys

Summary The aim of this study was to investigate the effect of growth on ventilation and breathing pattern during maximal exercise oxygen consumption (VO_2max and their relationships with anthropometric characteristics. Seventy six untrained schoolboys, aged 10.5–15.5 years, participated in this study. Anthropometric measurements made included body mass, height, armspan, lean body mass, and body surface area. During an incremental exercise test, maximal ventilation (V_Emax), tidal volume (V _Tmax), breathing frequency (f _max), inspiratory and expiratory times (t _Imax and t _Emax), total duration of respiratory cycle (t _TOTmax), mean inspiratory flow (V _T/t _Imax), and inspiration fraction (t _I/t _TOTmax) were measured at VO_2max. A power function was calculated between anthropometric characteristics and ventilatory variables to determine the allometric constants. The results showed firstly, that V_Emax, V _Tmax, t _Imax, t _Emax, t _TOTmax, and V _T/t _Imax increased with age and anthropometric characteristics (P<0.001), f _max decreased (P<0.001), and t _I/t _TOTmax remained constant during growth; secondly that lean body mass explained the greatest percentage of variance of V_Emax (62.1%), V _Tmax (76.8%), and V _T/t _Imax (70.6%), while anthropometric characteristics explained a slight percentage of variance of f _max and timing; and thirdly that V_Emax, V _Tmax, and V _T/t _Imax normalized by lean body mass did not change significantly with age. We concluded that at VO_2max there were marked changes in ventilation and breathing pattern with growth. The changes in V_Emax, V _Tmax, and V _T/t _Imax were strongly related to the changes in lean body mass.     

新生儿窒息对血糖的影响

目的探讨新生儿窒息引起的血糖变化,并分析窒息程度与血糖变化的关系。方法对窒息组及对照组新生儿进行血糖测定,并对结果进行比较分析。结果新生儿轻度窒息存在低血糖,而重度窒息时血糖升高。结论注意监测血糖,保持血糖稳定,减轻脑损伤。     

母亲被动吸烟对新生儿行为神经的影响

采用双盲法对４６５足月正常新生儿进行２０项行为神经测定（ＮＢＮＡ）及孕母是否被动吸烟歼体格发育进行调查，二组间孕母及新生儿的情况及影响因素无差异，说明不论孕母是否被动吸烟，地胎儿体格发育（除体重外）受到均匀的影响。父亲吸烟和与母亲被动吸烟小时数成正比，有显著差异。     

The relationship of the anthropometric variables to the infusion rate of rocuronium in the elderly

We have determined the infusion rates of rocuronium in the elderly and young adult patients during sevoflurane and nitrous oxide anesthesia. The correlation of some anthropometric predictors with infusion rate of rocuronium was also investigated for both elderly and young adult. Participating patients were assigned to one of two groups: 1) young adult patients aged 20 to 50 years (n = 30); 2) elderly patients aged over 65 years (n = 30). The anthropometric variables such as height, weight, ratio of weight to body surface area, subscapularis and suprailiac skin folds, body surface area, body mass index and % ideal body weight were evaluated as predictors for infusion rate. The infusion rate in elderly patients was significantly less compared with that in young adult patients (p < 0.05). In elderly patients, no anthropometric predictor was related to the infusion rate of rocuronium. This suggests that the infusion rate of rocuronium for an elderly patient needs to be individualized by monitoring neuromuscular transmission to avoid excessive dose.     

Birth weight and anthropometric measurements of twins

Background: Genetic and environmental influences on anthropometric measures can be investigated by comparing dizygotic (DZ) versus monozygotic (MZ) twins. Investigating cohorts living in different geographical areas across the globe can identify the variation in heritability versus environment.

Aims: (1) To investigate the association between birth weight and anthropometric measurements during adulthood; (2) to study the genetic and environmental influences on body measures including birth weight, weight and height among twins; and (3) to assess the variation in heritability versus environment among two cohorts of twins who lived in different geographical areas.

Subjects and methods: Twins were collected from two twin registers. Data on birth weight, adult weight and height in 430 MZ and 170?DZ twins living in two geographically distinct parts of the world were collected. A genetic analysis was performed using MX software.

Results: Birth weight was associated with weight, height and BMI. Both MZ and DZ twins with low birth weight had shorter height during their adult life (p?=?0.001), but only MZ twins with lower birth weight were lighter at adulthood (p?=?0.001). Intra-pair differences in birth weight were not associated with differences in adult height (p?=?0.366) or weight (p?=?0.796). Additive genetic effects accounted for 53% of the variance in weight, 43% in height and 55% in birth weight. The remaining variance was attributed to unique environmental effects (15% for weight, 13% for height and 45% for birth weight and only 16% for BMI). Variability was found to be different in the two cohorts. The best fitting model for birth weight and BMI was additive genetic and non-shared environment and for weight and height was additive genetic, non-shared environment (plus common Environment).

Conclusions: Data suggests that the association between weight at birth and anthropometric measures in later life is influenced by both genetic and environmental factors. Living in different environments can potentially relate to variation found in the environment.     

新生儿脑水肿136例临床病理分析

根据本院1989年-1993年136例新生儿脑水肿尸解结果进行分析。轻度60例，重度76例。本文认为新生儿的脑水肿诊断线索为：①凡中枢神经系统反应低下，呼吸、循环系统功能障碍者，应怀疑脑水肿，有呼吸困难、肌张力低下、肢体震颤多为重庆脑水肿。②重度窒息并有二氧化碳潴留多为重度脑水肿，无窒息并有低钠血症者多为轻度脑水肿：两者均有不同程度酸中毒，其次为低氧血症和低钙血症。本文认为：治疗脑水肿应以治疗原发病为基础，纠正缺氧及酸中毒为主要环节，及早使用脱水剂、利尿剂、钙通道阻滞剂，控制入量，酌情补纳为重点。     

窒息新生儿免疫功能变化及其临床意义的研究

目的观察窒息新生儿免疫功能的动态变化.方法选择40例窒息新生儿作为观察对象,同时选择30例健康新生儿作为对照组,于生后第1d和第10d两次采血,分别检测CD23、IgG、IgA、IgM、CD3、CD4、CD8等免疫指标.结果治疗前窒息新生儿与对照组相比细胞免疫和体液免疫功能明显抑制,且与窒息程度成正比.治疗后第10天重新检测各免疫指标,重度窒息组细胞免疫和体液免疫功能虽较治疗前好转,但仍低于对照组.轻度窒息组各免疫指标和对照组相比无明显差异.结论窒息新生儿免疫功能明显抑制,且与窒息程度成正比,重度窒息患儿免疫功能恢复较慢.     

Evaluation of some anthropometric indices for the diagnosis of obesity in pregnancy in Nigeria: a cross-sectional study

Background

Obesity in pregnancy is a global health problem which is associated with poor pregnancy outcomes. The use of weight and height, measured at about ten weeks of gestation, to produce pre-gestational body mass index is recommended for the diagnoses of the condition but limitations abound in under resourced settings.

Objectives

To measure anthropometric indices such as mid upper arm circumference, calf circumference, waist circumference and waist to hip ratio, for identification of obesity in pregnancy.

Methods

Anthropometric measurements were carried out on cohorts of pregnant women from 4 hospitals in Enugu, South-eastern Nigeria.

Results

There were no significant difference in the mean mid upper arm circumference (MUAC) and calf circumference (CC) across the trimester groups. The mean values of waist circumferences, hip circumference and waist to hip ratios changed significantly across the trimesters. The 75^th percentile of MUAC (33 cm) and CC (39 cm) in all trimesters, had sensitivity and specificity of more than 70% for identifying obesity in pregnancy.

Conclusion

MUAC and CC values of 33cm and 39cm respectively might be reliable cut off points for diagnoses of obesity throughout pregnancy in Enugu, Nigeria     

39例分娩性臂丛神经损伤新生儿的神经电生理评价

目的:探讨新生儿期电生理检测在评价分娩性臂丛神经损伤中的价值。方法:应用肌电一诱发电位仪对39例分娩性臂丛神经损伤新生儿进行检测。测试项目包括:①患侧臂丛神经五大分支腋神经、肌皮神经、正中神经、尺神经及桡神经运动神经传导速度测定;患侧正中神经、尺神经及桡神经感觉神经传导速度测定;②采用同芯针电极检测臂丛神经支配远端肌肉(三角肌、肱二头肌、4伸指总肌、外展拇短肌、外展小指肌或骨问肌)肌电图。结果:39例新生儿中全臂丛神经损伤11例(28％);上干损伤18例(46％);下干损伤3例(8％);后束损伤7例(18％)。节前损伤11例(28％)。结论:新生儿期神经电生理检测对早期评价分娩性臂丛神经损伤的范围、性质、部位及程度具有重要的临床价值。