Obesity measures at baseline,their trajectories over time,and the incidence of chronic kidney disease: A 14 year cohort study among Korean adults

Background and aimsWe investigated the association of baseline obesity measures, i.e. body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-hip ratio (WHR), and their trajectories over time with incident chronic kidney disease (CKD).Methods and resultsUtilizing data from 2001 to 2014 for 9796 Korean adults without CKD at baseline, the association of baseline obesity measures with incident CKD was evaluated using logistic regression. Further, among 5605 subjects with repeated measures, the effect of the trajectories in obesity measures on CKD incidence was investigated via Cox regression.Baseline obesity in terms of BMI, WC, and HC increased the odds of incident CKD (odds ratio (OR) 1.19, 95% confidence interval (CI) 1.05–1.33; OR 1.22, 95% CI 1.07–1.38; and OR 1.25, 95% CI 1.11–1.41, respectively), while baseline WHR did not show such an association. A “became non-obese” BMI, WC, or WHR trajectory, and a “constantly not large” HC trajectory decreased the hazard of incident CKD (hazard ratio (HR) 0.70, 95% CI 0.50–0.99; HR 0.61, 95% CI 0.40–0.92; HR 0.55, 95% CI 0.35–0.85; and HR 0.81, 95% CI 0.69–0.95, respectively) when compared with a “constantly obese or became obese” trajectory.ConclusionBoth baseline obesity and obesity trajectories over time were associated with CKD incidence. BMI and WC were equally good measures of CKD risk, while WHR was not. Separately examining WC and HC components of WHR (= WC/HC) may explain WHR's inconsistency, and WHR's usefulness as a measure of CKD risk should be reevaluated.     

超重和肥胖人群血清脂联素水平与2型糖尿病的关系

目的研究血清脂联素水平与超重、肥胖及与血糖（PG）的关系。方法对深圳地区21～60岁人群共29799人进行BMI，腰围（WC），腰臀围比（WHR）及血糖检测，按BMI高低分成三大组：正常非肥胖（NC）组（BMI≤24）男10267人、女14268人；超重（OW）组（24〈BMI〈28）男2952人、女1800人；和肥胖（Ob）组（BMI≥28）男245人、女267人。Ob组按血糖水平又分为单纯肥胖（S-Ob）组（男190人，女216人）和2型糖尿病肥胖（T2DM-Ob）组（男55人，女51人）。调查三大组人群T2DM的患病率，分析BMI、WC、WHR与T2DM的关系，并测定各组人群的血清脂联素水平。结果T2DM的患病率在NC组男性和女性分别为32‰和35‰；在OW组的男性和女性分别为126‰和106‰；在肥胖组的男性和女性分别为225‰和191‰。T2DM的患病率在男性WC〉85cm者显著高于WC≤85cm者，在女性，WC〉80cm者显示高于WC≤80cm者（P均〈0．01）。血清脂联素浓度在Ow组、Ob组及T2DM—Ob组均显著低于NC组（P=0．000）。在T2DM—Ob患者中，脂联素浓度与BMI、WC、WHR、PG呈显著负相关。结论脂联素浓度变化可能与肥胖及糖尿病密切相关。保持BMI和WC在正常范围，是预防糖尿病发生的有效措施之一。     

Association between dairy consumption,dietary calcium intake and general and abdominal obesity among Iranian adults

Aim

To assess the association of dairy consumption and dietary calcium intake with general and abdominal obesity in a large sample of Iranian adults.

Waist-to-height ratio,waist circumference,body mass index,waist divided by height0.5 and the risk of cardiometabolic multimorbidity: A national longitudinal cohort study

Background and aimsCardiometabolic multimorbidity (CM) is an increasing public health burden. This study aimed to evaluate the association of waist-to-height ratio (WHtR), waist circumference (WC), waist divided by height^0.5 (WHT.5R) and body mass index (BMI) with the risk of CM.Methods and resultsWe used data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 10,521 participants aged 45 years and over were recruited, including 8807 individuals with 0 cardiometabolic diseases at baseline (stage I) and 1714 individuals with 1 cardiometabolic disease at baseline (stage II). CM was defined as self-reporting of two or more of the following conditions: stroke, diabetes and heart disease. Logistic regression was conducted to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). The net reclassification index (NRI) and integrated discrimination improvement (IDI) were used to evaluate the incremental predictive value beyond conventional factors. In stage I, an increased risk of CM was observed among participants with WHtR ≥0.5 (OR: 1.76, 95% CI: 1.05–2.97), WC ≥ 90 cm (men) + WC ≥ 80 cm (women) (OR: 2.06, 95% CI: 1.29–3.27), WHT.5R ≥ 6.54 cm^0.5 (OR: 1.81, 95% CI: 1.16–2.83) or BMI ≥24 kg/m² (OR: 1.48, 95% CI: 0.98–2.24). Furthermore, the NRI and IDI of WHtR, WC and WHT.5R were all higher than those of BMI. In stage II, the adjusted ORs (95% CIs) of WHtR, WC, WHT.5R and BMI were 2.04 (1.24–3.35), 1.89 (1.29–2.77), 1.86 (1.24–2.78) and 1.47 (1.06–2.04), respectively. In addition, WC exhibited the highest NRI and IDI.ConclusionWHtR, WC, WHT.5R and BMI are independent predictors of CM in the middle-aged and older Chinese population. WHtR, WC and WHT.5R show better abilities in predicting CM than BMI.     

福州成年人群体成分与高血压风险评估

目的 分析福州地区成年人群体成分特点并建立估测体脂含量(%BF)的回归方程,评估%BF对高血压患病风险的预测价值.方法 抽样人群602人(男性310人,女性292人),各年龄层人数比符合福州地区常住(5年及以上)居民年龄构成比.测量人选人群的血压、身高、体重、腰围、体重指数(BMI)等,应用双能X线骨密度仪(DEXA)检测体成分指标(总体脂肪、瘦组织质量).分析抽样人群的腰围、BMI和体成分特征,X2检验分析与BMI≥25 kg/m2诊断一致性的腰围和%BF切点,多元回归分析建立估测人群%BF的回归方程,logistic回归分析%BF对高血压患病风险的预测.结果 成年男、女性人群的%BF、脂肪质量/瘦组织质量随年龄增长而增加,女性%BF明显高于男性.与BMI≥325 kg/m2诊断一致性最高的腰围和%BF切点分别为85 cm、25%(男)和80 cm、35%(女).Logistic回归分析显示,年龄每增加一个等级的高血压患病比数比为1.49(男)和1.75(女),%BF每增加一个等级的高血压患病比数比为1.57(男)和1.65(女),BMI和腰围未能进入回归方程.结论 与BMI 25 kg/m2作为肥胖判定切点一致的%BF切点为25%(男)和35%(女),体成分分析能更好地预测高血压的患病风险.     

重庆地区人群体重指数腰围与血压水平及高血压关系的分析

目的 探讨重庆地区人群体重指数（BMI）、腰围（WC）与血压水平及高血压的关系。方法 采用分层整群抽样的方法,抽取重庆地区15岁以上城乡人口5246人进行血压、脉搏、身高、体重、腰围、臀围的测量,并问卷调查。结果 重庆地区人群收缩压、舒张压水平及高血压患病率均随着BMI的增加呈明显的线性上升趋势（线性趋势检验P〈0．01）。腹型肥胖的人群收缩压、舒张压水平及高血压患病率均高于腰围正常的人群,差异均有统计学意义（线性趋势检验P〈0．01）。按BMI分组[〈18．5、18．5～23．9、24．0～27．9、≥28．0（kg／m。）]的高血压患病率分别为9．39％、13．51％、26．23％、32．21％;按WC分组（男〈85cm或女〈80cm,男≥85cm或女≥80cm）的高血压患病率分别为12、39％、28．81％。结论 重庆地区人群血压水平及高血压患病率均与BMI、WC密切相关。BMI、WC是高血压的重要危险因素,对于高血压的发生有着重要的预测作用。     

Association of body mass index with risk of prediabetes in Chinese adults: A population‐based cohort study

Aims/IntroductionOverweight and obesity in adults are strongly associated with an increased risk of prediabetes, and this study set out to gain a better understanding of the optimal body mass index (BMI) range for assessing the risk of prediabetes in the Chinese population.Materials and MethodsThe cohort study included 100,309 Chinese adults who underwent health screening. Participants were divided into six groups based on the cut‐off point for BMI recommended by the World Health Organization (underweight: <18.5 kg/m², normal‐weight: 18.5–24.9 kg/m², pre‐obese: 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). The association of BMI with prediabetes and the shape of the correlation were modeled using multivariate Cox regression and restricted cubic spline regression, respectively.ResultsIn the multivariate Cox regression model, with normal weight as the control group, underweight people had a lower risk of developing prediabetes, whereas obese and pre‐obese people had a higher risk of prediabetes. Additionally, in the restricted cubic spline model, we found that the association of BMI with prediabetes follows a positive dose–response relationship, but does not conform to the pattern of obesity paradox. Among the general population in China, a BMI of 23.03 kg/m² might be a potential intervention threshold for prediabetes.ConclusionsThe national cohort study found that the association of BMI with prediabetes follows a positive dose–response relationship, rather than a pattern of obesity paradox. For Chinese people with normal weight, more attention should be paid to glucose metabolism when BMI exceeds 23.03 kg/m².     

中国成人体重指数和腰臀围比值分布特征的探讨

目的 探讨中国成人体重指数（ＢＭＩ）和腰臀围比值（ＷＨＲ）的分布特征。方法 从１９９４年全国糖尿病防治协作组资料库中选取１６３５４例具有完整糖耐量试验（ＯＧＴＴ）资料的中国成人（≥２５岁）,按不同性别、不同年龄段（２５～３４岁,３５～５４岁,５５～６４岁,≥６５岁）、不同血糖水平和不同纬度地区（北部、中部和南部）分组进行统计分分析。结果 总体人群男女两性的ＢＭＩ均为２４．３ｋｇ／ｍ＾２以不同年龄段     

Skeletal muscle mass and risk of death in an elderly population

Background and aimBody mass index (BMI) has a U-shaped relationship with mortality among the elderly, in contrast to the general adult population. Skeletal muscle mass may be more appropriate than BMI for classifying mortality risk among the elderly. We investigated the relationship between skeletal muscle mass and mortality among elderly Chinese persons.Method and resultsA total of 1512 elderly from the Nutrition and Health Survey in Taiwanese Elderly (1999–2000) was enrolled, and the survival status was followed using data from the National Death Registry. The skeletal muscle mass index (SMMI) was calculated by dividing skeletal muscle mass by height in meters squared. The Cox proportional hazard model was used to estimate the association between SMMI and mortality. During the follow-up (average time: 7.9 years), one-third elderly died (n = 506) by any cause and 25% of them was cardiovascular mortality (ICD-9-CM: between 390 and 459). The total mortality and cardiovascular mortality were 4.23 and 1.07 per 100 person-years. Elderly participants with the lowest SMMI had the highest total mortality and cardiovascular mortality among the four quartiles (6.72, 3.76, 3.25 and 3.50 per 100 PY for total mortality; 1.81, 0.76, 0.87, 0.93 for cardiovascular mortality). Those with a low (1st quartile) SMMI had a 2-fold increase in total mortality (1.96; 1.63–2.35) and cardiovascular mortality (2.16; 1.51–3.08) risk compared to those with a normal [2nd, 3rd, or 4th quartile] SMMI.ConclusionsThe threshold relationship between SMMI and mortality is contrast to the reverse J-shaped relationship between BMI and total mortality. Therefore, skeletal muscle mass measurement may be considered with a high priority to identify elderly individuals with a high mortality risk.     

体重指数和腰围与代谢综合征发生风险的比较研究

目的 比较体重指数、腰围与代谢综合征发生风险的相关性.方法 554例人选者(男316例,女238例),按照体重指数和腰围被分为周围肥胖组192例、腹部肥胖组135例和混合肥胖组237例,7年后进行随访.结果 共随访到520例.周围肥胖组代谢综合征累积发生率26.3%(49/186),腹部肥胖组代谢综合征累积发生率41.7%(50/120),混合肥胖组代谢综合征累积发生率43.0%(92/214).腹部肥胖组和混和肥胖组代谢综合征累积发生率显著高于周围肥胖组(X2分别为7.825和12.082,均P＜0.01),且基线时舒张压、甘油三酯、空腹血糖、空腹胰岛素及稳态模型评估法胰岛素抵抗指数(HOMA-IR)也显著高于前者(均P＜0.05).以有或无代谢综合征分组后基线资料比较,代谢综合征组无论男女,腰围和腰臀比均高于非代谢综合征组(P＜0.01和P＜0.05),体重指数在两组无统计学差异,并且代谢综合征组空腹血糖、空腹胰岛素和HOMA-IR显著高于非代谢综合征组(均P＜0.05).Logistic回归显示,与代谢综合征发生风险相关的因素主要为腰围(P=0.021)、腰臀比(P=0.009)、HOMA-IR(P=0.004).结论 腹部脂肪堆积及胰岛素抵抗是代谢综合征发生的两个重要因素,腰围比体重指数与代谢综合征的发生风险关系更密切.     

Comparison of anthropometric indices (body mass index,waist circumference,waist to hip ratio and waist to height ratio) in predicting risk of type II diabetes in the population of Yazd,Iran

Background and objectives

The purpose of this study was to determine the best anthropometric index and calculate the cut-off point for each anthropometric index in predicting the risk of type II diabetes in the population of Yazd city in Iran.

体质指数与腰围指标联合应用对心血管病危险的预测作用

目的 分析和评价在体质指数(BMI)分层基础上,增加腰围指标对心血管病危险因素的检出作用以及对心血管病发病危险的预测作用.方法 以1992年建立的中国多省市前瞻性队列35～64岁共30 378人数据为依据,在基线BMI分为正常、超重和肥胖的基础上,分析和评价加入腰围指标对心血管病代谢因素的检出作用以及心血管病发病危险的预测作用.诊断标准分别参照<中国成人超重和肥胖症预防控制指南>中的BMI切点和<中国成人血脂异常防治指南>中的腹部肥胖切点.结果 (1)联合应用BMI和腰围指标诊断肥胖时,呈现交叉重叠情况.以BMI为标准,队列人群肥胖率是10%,其中76.4%的人同时伴有腹部肥胖;以腰围为标准诊断人群腹部肥胖率为17.5%,其中有43.4%的人同时符合BMI的肥胖标准.(2)在BMI分层中加入腰围指标,男女两性有腹部肥胖者其心血管病危险因素患病率均高于无腹部肥胖组.在调整了年龄、性别、吸烟和体力活动等因素后,其特点仍存在,并有统计学的显著性.(3)以BMI和腰围均正常组为对照,多因素分析显示:超重和肥胖组中有腹部肥胖者的缺血性心血管病发病危险分别增加了38%(RR=1.383,95%CI 1.083～1.765)和57%(RR=1.570,95%CI 1.226～2.010).结论 在BMI分层中加入腰围指标可增加心血管病代谢危险因素以及心血管病发病危险的预测作用.     

Gender-specific associations of body mass index and waist circumference with type 2 diabetes mellitus in Chinese rural adults: The Henan Rural Cohort Study

Aim

To assess the relationship between various obesity categories according to body mass index (BMI) and waist circumference (WC) and risk of type 2 diabetes mellitus (T2DM) among Chinese rural adults.

Resistin is not an appropriate biochemical marker to predict severity of acute pancreatitis: A case-controlled study

AIM: To assess levels of serum resistin upon hospital admission as a predictor of acute pancreatitis (AP) severity.METHODS: AP is both a common and serious disease, with severe cases resulting in a high mortality rate. Several predictive inflammatory markers have been used clinically to assess severity. This prospective study collected data from 102 patients who were diagnosed with an initial acute biliary pancreatitis between March 2010 and February 2013. Measurements of body mass index (BMI) and waist circumference (WC) were obtained and serum resistin levels were analyzed at the time of hospital admission using enzyme-linked immunosorbent assay. Additionally, resistin levels were measured from a control group after matching gender, BMI and age.RESULTS: A total of 102 patients (60 females and 42 males) were diagnosed with acute gallstone-induced pancreatitis. The mean age was 45 years, and mean BMI value was 30.5 kg/m² (Obese, class I). Twenty-two patients (21.6%) had severe AP, while eighty-eight patients had mild pancreatitis (78.4%). Our results showed that BMI significantly correlated with pancreatitis severity (P = 0.007). Serum resistin did not correlate with BMI, weight or WC. Furthermore, serum resistin was significantly higher in patients with AP compared to control subjects (P < 0.0001). The mean resistin values upon admission were 17.5 ng/mL in the severe acute biliary pancreatitis group and 16.82 ng/mL in the mild AP group (P = 0.188), indicating that resistin is not an appropriate predictive marker of clinical severity.CONCLUSION: We demonstrate that obesity is a risk factor for developing severe AP. Further, although there is a correlation between serum resistin levels and AP at the time of hospital admission, resistin does not adequately serve as a predictive marker of clinical severity.     

Anthropometric measures of abdominal adiposity for the identification of cardiometabolic risk factors in adolescents

Sagittal abdominal diameter (SAD) was obtained in 65 adolescents referred for assessment of cardiometabolic risk. We found that SAD was associated with cardiometabolic risk factors independent of BMI in males, but that SAD was not superior to BMI or other measures of abdominal adiposity for the detection of metabolic syndrome.     

Prevalence of cardiovascular risk factors in middle-aged Lithuanian women in different body mass index and waist circumference groups

Background and aimsThe aim of this study was to evaluate the prevalence of cardiovascular risk factors in middle-aged Lithuanian women in different body mass index and waist circumference groups.Methods and resultsData selected from the Lithuanian High Cardiovascular Risk (LitHiR) primary prevention program between 2009 and 2016. This community-based cross-sectional study comprised 53,961 women aged 50–64 years old. We compared the prevalence of arterial hypertension, dyslipidaemia, diabetes mellitus, smoking, and metabolic syndrome in different body mass index (BMI) and waist circumference (WC) groups. The most prevalent cardiometabolic risk factor was dyslipidaemia (91.71%, n = 49,488). The prevalence of arterial hypertension, dyslipidaemia, diabetes mellitus, and metabolic syndrome was greater in those with higher-than-normal BMI and WC. Smoking was the most prevalent in women with low BMI and normal WC (24.00% and 13.17% respectively).ConclusionThe analysis showed that all risk factors, except smoking, were significantly more prevalent in women with higher-than-normal BMI and with increased WC or abdominal obesity. The prevalence of dyslipidaemia was surprisingly high in all BMI and WC groups. Obesity measured by WC was more strongly associated with an adverse metabolic profile.     

非糖尿病人群肥胖相关指数与胰岛素抵抗的关联

青岛市区30-74岁的居民724名（NGT者447名，IGT者277名）。WC、WHR及BMI同胰岛素抵抗指数的相关性（分别为0．45、0．33、0．47），与WC、WHR及BMI同Fins的相关性（分别为0．44、0．33、0．45）几乎完全一致。