Obesity, abdominal obesity, and clustering of cardiovascular risk factors in South Korea

The aim of this study was first, to investigate the prevalence of obesity, abdominal obesity, and clustering of cardiovascular (CVD) risk factors, and secondly, to identify the BMI or waist circumference (WC) level at which clustering increases in South Koreans. A population-based, cross-sectional National Health Examination Survey was carried out in 1998. A total of 8,816 subjects (4,029 men and 4,787 women) aged 15-79 y were selected by stratified multistage probability sampling design. The measurements taken of the subjects included: height, weight, waist and hip circumference, blood pressure, fasting glucose, and lipids. The prevalence of BMI > or = 25 kg/m2 was 25.3% for men and 28.3% for women. The prevalence of WC >90 cm in men, and >80 cm in women was 18.5%, and 38.5%, respectively. Clustering of 3 or more CVD risk factors was 22.7% in men ad 21.7% in women. Using <21 kg/m2; as a referent, subjects with BMI of 23 kg/m2; and 27 kg/m2; had an odds ratio of 3.5 and 10.2 in men, and 3.1 and 6.7 in women, respectively for clustering of CVD risk factors. Using <65 cm as a referent, subjects with a WC of > or = 90 cm in men and > or = 85 cm in women had an odds ratio of 13.4, and 13.6, respectively for clustering of CVD risk factors. Considering the significant associations between clustering of CVD risk factors and BMI or WC, the present study suggests that high prevalence of overweight may have important implications for the health care system, even at a lower level of BMI or WC.     

Size at birth and glucose intolerance in a relatively genetically homogeneous,high-birth weight population

BACKGROUND: The results of epidemiologic studies have linked birth size to adult glucose intolerance. OBJECTIVE: We investigated this association in a genetically homogeneous population with higher birth weights and a lower prevalence of type 2 diabetes than previously studied. DESIGN: The subjects were 2362 men and 2286 women aged 33-65 y. Size at birth was obtained from the National Archives of Iceland. Data for adult anthropometry, fasting blood glucose, and blood glucose after an oral glucose load came from the randomized prospective Reykjavík Study. RESULTS: Postchallenge glucose concentrations were inversely related to birth weight and length in men and inversely related to birth weight and ponderal index in women (P < 0.001). This association was mainly found among those within the highest one-third of adult body mass index values. In men, the prevalence of dysglycemia was lower with increasing weight (P = 0.04) and length (P = 0.003) at birth but there was no relation of dysglycemia to ponderal index. For women, there was no linear trend for dysglycemia in relation to size at birth but the relation with birth length was U shaped. CONCLUSIONS: Greater birth weight and length appear to offer a protective effect against glucose intolerance. Adult overweight or obesity enhances the risk associated with low birth weight and length. Because the population studied has higher birth weights and a lower prevalence of type 2 diabetes than are found in neighboring countries, it is possible that decreasing the number of low-birth weight infants might help to stem the increasing prevalence of type 2 diabetes worldwide.     

A study of cardiovascular risk in overweight and obese people in England

Objectives: To report current levels of obesity and associated cardiac risk using routinely collected primary care computer data. Methods: 67 practices took part in an educational intervention to improve computer data quality and care in cardiovascular disease. Data were extracted from 435 102 general practice computer records. 64.3% (229 108/362 861) of people age 15 y and older had a body mass index (BMI) recording or a valid height and weight record that enabled BMI to be derived. Data about cardiovascular disease and risk factors were also extracted. The prevalence of disease and the control of risk factors in the overweight and obese population were compared with those of normal body weight. Results: 56.8% of men and 69.3% of women aged over 15 y had a BMI record. 22% of men and 32.3% of women aged 15 to 24 y were overweight or obese; rising each decade to a peak of 65.6% of men and 57.5% of women aged 55 to 64 y. Thereafter, the proportion who were overweight or obese declined. The prevalence of ischaemic heart disease, diabetes mellitus and hypertension rose with increasing levels of obesity; their prevalence in those who are moderately obese was between two and three times that of the general population. Systolic and diastolic blood pressure, blood glucose even in non-diabetics, cholesterol and triglycerides were all elevated in the overweight and obese population.

Conclusion: Based on the recorded data over half of men and nearly half of women are overweight or obese. They have increased cardiovascular risk, which is not adequately controlled by current practice.     

Birth weight, childhood growth, and cardiovascular disease risk factors in Japanese aged 20 years

To determine whether birth weight and childhood growth, especially rate of height increase, are independently related to major cardiovascular disease risk factors in adult life, the authors conducted a 20-year follow-up study in a Japanese population, using the record-linkage method. From medical checkup data for babies and for residents aged 20 years in Ishikawa, Japan, the authors obtained 20-year follow-up data (1985-1994) on 4,626 participants (2,198 men and 2,428 women) born in 1965-1974. Using multiple linear regression analysis, the authors estimated that a 1-standard-deviation higher birth weight was significantly associated with systolic blood pressure that was lower by 1.6 mmHg in men and by 1.0 mmHg in women, and with a serum cholesterol level that was lower by 0.07 mmol/liter in men and by 0.04 mmol/liter in women, after adjustment for current weight and rate of height increase. Moreover, after adjustment for birth weight and current weight, a 1-standard-deviation higher rate of height increase from age 3 years to age 20 years was significantly associated with systolic blood pressure that was lower by 0.7 mmHg in men and by 0.5 mmHg in women, and with serum cholesterol that was lower by 0.09 mmol/liter in men and by 0.05 mmol/liter in women. The results suggest that lower birth weight and lower rate of height increase during childhood are independently associated with increases in blood pressure and serum cholesterol in adult life.     

Carbohydrate intake is associated with diet quality and risk factors for cardiovascular disease in U.S. adults: NHANES III

OBJECTIVES: To determine if carbohydrate intake, as a % of energy, was related to diet quality and risk factors for cardiovascular disease (CVD) in adults in a cross-sectional and population-based study in the U.S. METHODS: Data from the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) were utilized. The nationally representative sample of the U.S. population (3,754 men, 4,074 women, ages 25 to 64 years) was divided into quintiles of carbohydrate intake (% of energy), which was examined in relation to risk factors for CVD: systolic blood pressure, body mass index (BMI), and concentrations of serum triglyceride, serum total and HDL cholesterol and plasma glucose. RESULTS: When covariates (age, ethnicity, smoking, alcohol intake and total energy intake) were adjusted in multivariate analyses, carbohydrate intakes (% of energy) were inversely associated with BMI and serum total cholesterol concentration in men and BMI in women and positively associated with serum triglyceride concentration in women. When total sugar intake (% of energy) was further controlled as a step to understand the quality of carbohydrate, carbohydrate intakes (% of energy) was a stronger predictor of BMI and plasma glucose in men and BMI in women. A high carbohydrate diet (>57.4% of energy in men and >59.1% of energy in women) was associated with a low serum HDL-cholesterol concentration in men and high serum triglyceride in women. CONCLUSION: Moderately high carbohydrate (50% to 55% of energy) diets were associated with low CVD risks with favorable lipid profiles.     

社区高血压病人体质指数相关因素分析

目的了解社区高血压患者体质指数（BMI）和其他心脑血管疾病的危险因素的分布特点、冠心病发病风险、及它们间的相关情况。方法通过全人群现场调查和血压测量发现疑似病例，2w后对疑似病例复查来确诊高血压患者，对高血压患者进行详细的体检和血液的化验检查。对2015例确诊的社区高血压患者的资料进行统计分析。结果高血压患者中男性、女性的超重或肥胖患病率分别为57．2％、55．4％，远高于一般人群的患病率；BMI与甘油三酯（TG）、总胆固醇（TC）与高密度脂蛋白胆固醇（HDL—C）比值、低密度脂蛋白胆固醇（LDL—C）与高密度脂蛋白胆固醇（HDL-C）比值、TG／HDL—C、血糖的水平呈正相关，与HDL—C水平呈负相关；BMI与未来10a冠心病的预测发病风险呈正相关；超重或肥胖患者中危险因素水平、异常率高于正常体重组。结论高血压患者伴发超重或肥胖时，心脑血管病的发病风险增加，为了预防和控制心脑血管疾病的发生，应及早控制并减轻体重。     

Divergent associations of plasma choline and betaine with components of metabolic syndrome in middle age and elderly men and women

Choline is involved in the synthesis of phospholipids, including blood lipids, and is the immediate precursor of betaine, which serves as a methyl group donor in a reaction converting homocysteine to methionine. Several cardiovascular risk factors are associated with plasma homocysteine, whereas little is known about their relationship to choline and betaine. We examined the relation of plasma choline and betaine to smoking, physical activity, BMI, percent body fat, waist circumference, blood pressure, serum lipids, and glucose in a population-based study of 7074 men and women aged 47-49 and 71-74 y. Overall plasma concentrations (means +/- SD) were 9.9 +/- 2.3 micromol/L for choline and 39.5 +/- 12.5 micromol/L for betaine. Choline and betaine were lower in women than in men and in younger subjects compared with older (P < 0.0001). Multivariate analyses showed that choline was positively associated with serum triglycerides, glucose, BMI, percent body fat, waist circumference (P < 0.0001 for all), and physical activity (P < 0.05) and inversely related to HDL cholesterol (P < 0.05) and smoking (P < 0.0001). Betaine was inversely associated with serum non-HDL cholesterol, triglycerides, BMI, percent body fat, waist circumference, systolic and diastolic blood pressure (P < 0.0001 for all), and smoking (P < 0.05) and positively associated with HDL cholesterol (P < 0.01) and physical activity (P < 0.0001). Thus, an unfavorable cardiovascular risk factor profile was associated with high choline and low betaine concentrations. Choline and betaine were associated in opposite directions with key components of metabolic syndrome, suggesting a disruption of mitochondrial choline dehydrogenase pathway.     

Adherence index based on the AHA 2006 diet and lifestyle recommendations is associated with select cardiovascular disease risk factors in older Puerto Ricans

In 2006, the AHA released diet and lifestyle recommendations (AHA-DLR) for cardiovascular disease (CVD) risk reduction. The effect of adherence to these recommendations on CVD risk is unknown. Our objective was to develop a unique diet and lifestyle score based on the AHA-DLR and to evaluate this score in relation to available CVD risk factors. In a cross-sectional study of Puerto Rican adults aged 45-75 y living in the greater Boston area, information was available for the following variables: diet (semiquantitative FFQ), blood pressure, waist circumference (WC), 10-y risk of coronary heart disease (CHD) (Framingham risk score), and fasting plasma lipids, serum glucose, insulin, and C-reactive protein (CRP) concentrations. We developed a diet and lifestyle score (AHA-DLS) based on the AHA-DLR. The AHA-DLS had both internal consistency and content validity. It was associated with plasma HDL cholesterol (P = 0.001), serum insulin (P = 0.0003), and CRP concentrations (P = 0.02), WC (P < 0.0001), and 10-y risk of CHD score (P = 0.01 in women). The AHA-DLS was inversely associated with serum glucose among those with a BMI < 25 (P = 0.01). Women and men in the highest quartile of the AHA-DLS had lower serum insulin (P-trend = 0.0003) and CRP concentrations (P-trend = 0.002), WC (P-trend = 0.0003), and higher HDL cholesterol (P-trend = 0.008). The AHA-DLS is a useful tool to measure adherence to the AHA-DLR and may be used to examine associations between diet and lifestyle behaviors and CVD risk.     

Association between size at birth, truncal fat and obesity in adult life and its contribution to blood pressure and coronary heart disease; study in a high birth weight population

OBJECTIVE: The aim of the study was to assess the relationship between size at birth and obesity as well as truncal fat, and its contribution to cardiovascular risk in a high birth weight population. DESIGN: Cohort-study with retrospectively collected data on size at birth. SETTING: Reykjavik, Iceland. SUBJECTS: A total of 1874 men and 1833 women born in Reykjavik during 1914-1935. MAIN OUTCOME MEASURES: Size at birth. Adult weight, height and skinfold thickness measurements, systolic and diastolic blood pressure, fatal and nonfatal coronary heart disease (CHD). RESULTS: Birth weight was positively related to adult body mass index (BMI) in both genders (B=0.35+/-0.14 kg/m(2), adj. R(2)=0.015, P=0.012 and B=0.34+/-0.17 kg/m(2), adj. R(2)=0.055, P=0.043 in men and women, respectively). However, high birth weight was not a risk factor for adult obesity (BMI>/=30 kg/m(2)). In the highest birth weight quartile, the odds ratio (95% CI) for being above the 90th percentile of truncal fat was 0.7 (0.6-1.0, P=0.021) for men and 0.4 (0.3-0.8, P=0.002) for women, compared with the lowest birth weight quartile. Truncal fat and BMI were positively related to blood pressure in both genders (P<0.05), but not to CHD. The regression coefficient for the inverse association between birth weight and blood pressure hardly changed when adding truncal fat to the model. CONCLUSION: In this high birth weight population, high birth weight was related to higher BMI in adulthood without being a risk factor for adult obesity. The inverse association between birth weight and truncal fat in adulthood suggests a role for foetal development in determining adult fat distribution. The inverse relationship of birth weight to blood pressure seems not to be mediated through the same pathway as to truncal fat.     

Adiposity and cardiovascular disease risk factors in renal transplant recipients: Are there differences between sexes?

ObjectiveThe aim of this study was to evaluate high body adiposity and cardiovascular disease (CVD) risk factors prevalence, in renal transplant recipients (RTR), comparing men with women.MethodsIn this retrospective cross-sectional study, 102 patients (55 men) who were 49 ± 1.2 y and 114.3 ± 9 mo post-transplant (post-tx) were evaluated. Pretransplant (pre-tx) period data and weight gain during the first year post-tx were obtained from patient charts and post-tx data were collected during a routine visit at nephrology clinic. Body mass index (BMI) ≥ 25 kg/m² defined overweight and BMI ≥ 30 kg/m² defined obesity.ResultsPre-tx overweight prevalence was low and similar between men and women (26%), whereas only women showed obesity (11%). Post-tx body weight increased significantly in the entire group, leading to an increase in overweight (to 38% in men and 51% in women) and obesity (to 11% in men and 23% in women) prevalence. Post-tx comparisons between men and women showed that women had higher (women versus men; P < 0.05) BMI values (26.7 ± 0.8 versus 24.7 ± 0.5 kg/m²), weight gain during first year post-tx (9.2 ± 1.1 versus 5.5 ± 1 kg), abdominal obesity (57% versus 23%) and diabetes (34% versus 16%) prevalence. The associations between adiposity and CVD risk factors showed that pre-tx overweight increased the risk for diabetes in post-tx; pos-tx high BMI and abdominal obesity increased the risk for metabolic syndrome; abdominal obesity increased the risk for dyslipidemia in women.ConclusionsHigh body adiposity prevalence was high after transplantation and increased the risk for metabolic syndrome, an important CVD risk factor. Women showed higher total body adiposity values, abdominal obesity, and diabetes prevalence than men. Abdominal obesity increased the risk for dyslipidemia in women.     

Body mass index and short-term weight change in relation to mortality in Dutch women after age 50 y

BACKGROUND: The question of whether weight loss increases a person's longevity is important given the high prevalence of obesity and the large number of people trying to lose weight in industrialized countries. OBJECTIVE: This study assessed the effect of body mass index (BMI) and weight change (within 1 y of baseline) on subsequent mortality. DESIGN: This prospective cohort study had a median follow-up of 17 y. Subjects were 8100 women aged 50-66 y who participated in a population-based breast cancer-screening project in the Netherlands between 1974 and 1977. Weight and height were measured during the first and second screening visits. All women were followed until 1996 for causes of death. Cox proportional hazard analyses were conducted for mortality from all causes (n = 1269), cardiovascular disease (CVD; n = 402), and cancer (n = 492). RESULTS: During follow-up we observed a statistically significant increased risk of mortality from all causes (hazard ratio: 1.4; 95% CI: 1.2, 1.6), cardiovascular disease, and cancer for women in the highest quartile of BMI (in kg/m(2)), > or =27.77. Mortality from all causes, CVD, and cancer did not increase significantly in women with a weight gain of > or =15%. Weight loss was also not significantly related to mortality from all causes, CVD, and cancer. CONCLUSIONS: Mortality was highest for women in the highest BMI quartile (> or =27.77). Extreme weight gain or weight loss within 1 y was not statistically significantly associated with subsequent higher mortality.     

Persistent hypercholesterolemia is associated with the development of obesity among girls: the Bogalusa Heart Study

BACKGROUND: Obesity is associated with cardiovascular disease (CVD) risk factors. Cross-sectional data suggest that hypercholesterolemia is associated with the development of childhood obesity. OBJECTIVE: The objective was to assess age-related changes in relative weight and the association between relative weight and CVD risk factors in hypercholesterolemic and nonhypercholesterolemic children who were nonobese at baseline. DESIGN: Data on relative weight and CVD risk factors were extracted from the Bogalusa Heart Study for nonobese 5-6-y-old black and white hypercholesterolemic (LDL cholesterol > 75th percentile; n = 58) and nonhypercholesterolemic (LDL cholesterol < 60th percentile; n = 215) children (41% black, 52% girls) who were also assessed 3 and 6 y later. Changes in body mass index (BMI) and CVD risk factors were assessed as a function of age, sex, race, and cholesterol concentration. RESULTS: BMI increased more in the hypercholesterolemic (n = 31) than in the nonhypercholesterolemic (n = 111) girls during the 6 y of follow-up but was not significantly different between hypercholesterolemic (n = 27) and nonhypercholesterolemic (n = 104) boys aged 5-12 y. Associations between BMI and the risk factors blood pressure, insulin, and blood lipids were observed to be stronger with increasing age and, in some cases, stronger in hypercholesterolemic children and girls. CONCLUSIONS: Hypercholesterolemia is associated with increased relative weight in girls. The increased relative weight, even at an early age, is associated with a deleterious effect on blood lipids and other CVD risk factors in hypercholesterolemic children, although the strength of these associations is sex dependent.     

Hypophosphataemia in the metabolic syndrome. Gender differences in body weight and blood glucose.

OBJECTIVE: We examined gender differences in the clustering of risk factors, especially regarding the possible role of serum phosphate (S-P) in obese patients who participated in a 4 week education programme to reduce their excess risk of cardiovascular disease (CVD). RESULTS: Significantly higher body mass index (BMI) and concentrations of S-P and high density lipids (S-HDL) in serum were found in women (n=1272) than in men (n=993). In women, BMI was inversely correlated with S-P at the time of admission. Also in women (but not in men), changes in BMI and S-P over 1 or 1-1/2 y were inversely correlated. In men (but not in women), S-P level was inversely correlated with age, systolic blood pressure (SBP), diastolic blood pressure (DBP) and blood glucose at the time of admission. In women, S-P increased and DBP decreased, in addition to weight decrease over both 6 months and 1(1/2) y or 1 y. In women (but not in men), significantly higher age, S-P, S-chol, S-TG, S-urate, SBP and DBP values were found with the highest vs the lowest decile of S-Ca. CONCLUSION: We conclude that higher S-P and S-Ca levels may contribute to the difference in metabolic disturbances occurring in obesity, seen in women vs men.     

Are waist circumference and body mass index independently associated with cardiovascular disease risk in Chinese adults?

BACKGROUND: In Western populations, waist circumference (WC) is more predictive of cardiovascular disease (CVD) risk than is body mass index (BMI). It is unclear whether the same is true in Asian populations. OBJECTIVE: The objective was to examine the independent effects of WC and BMI on CVD risk factors in China. DESIGN: CVD risk factors, BMI, and WC were measured in a nationally representative cross-sectional study of 15 540 Chinese adults aged 35-74 y. RESULTS: Higher WC tertiles were associated with higher blood pressure and higher cholesterol, triacylglycerol, and glucose concentrations within each tertile of BMI and vice versa. In men, the odds of hypertension, dyslipidemia, and the metabolic syndrome (MS) increased with successive WC tertiles (1.0, 1.1, and 1.8, respectively, for hypertension; 1.0, 1.4, and 2.0, respectively, for dyslipidemia; and 1.0, 2.3, and 4.8, respectively, for MS; P for trend < 0.001 for all), even after adjustment for BMI. Similarly, the odds of hypertension, dyslipidemia, and MS increased with successive BMI tertiles (1.0, 1.5, and 2.6, respectively, for hypertension; 1.0, 1.3, and 1.8, respectively, for dyslipidemia; 1.0, 1.3, and 2.9, respectively for MS; P for trend < 0.001 for all), even after adjustment for WC. However, BMI tertiles were not associated with the odds of diabetes after adjustment for WC (P for trend = 0.67), whereas tertiles of WC were significantly associated with the odds of diabetes after adjustment for BMI (1.0, 1.6, and 2.1, respectively; P for trend = 0.002). The results were similar in women. CONCLUSIONS: These data show that WC adds additional risk information to that of BMI in Chinese adults. Measurement of both WC and BMI in Chinese adults may enhance CVD risk stratification.     

Iron stores and cardiovascular disease risk factors in women of reproductive age in the United States

BACKGROUND: The increasing proportion of iron-replete individuals in industrialized countries and the possible increased risk of cardiovascular disease (CVD) among men with high iron stores raise concerns regarding improved iron status in women of reproductive age. OBJECTIVE: This study examined the association between iron stores and a set of established CVD risk factors among nonpregnant women aged 20-49 y. DESIGN: Data from the third National Health and Nutrition Examination Survey (1988-1994) were used to examine the relation between race-ethnicity-specific quartiles of serum ferritin (SF) and a set of CVD risk factors [body mass index (BMI), total cholesterol, triacylglycerol, HDL cholesterol, plasma glucose, and blood pressure (BP)]. Women with a history of CVD or liver disease were excluded. We controlled for age, session of measurement, prevalent infection, recent blood donation, and treatment with iron for anemia. RESULTS: Mean SF values were 53.22 +/- 2.08 micro g/L (n = 1178), 58.93 +/- 2.39 micro g/L (n = 1093), and 43.33 +/- 1.39 micro g/L (n = 1075) among non-Hispanic white, non-Hispanic black, and Mexican American women, respectively. Iron stores were positively associated with CVD risk factors only among non-Hispanic black and Mexican American women after adjustment for confounding variables. The strongest associations were seen among Mexican American women: compared with the middle 2 quartiles, the lowest and highest quartiles of SF had lower and higher values, respectively, for BMI, total cholesterol, triacylglycerol, glucose, and diastolic BP. CONCLUSION: These findings suggest that CVD risk factors, especially those related to glucose and lipid metabolism, are positively associated with iron status in women.     

Prevalence of coronary risk factors in healthy adult Kuwaitis

Obesity has been shown to be a serious health risk and is associated with a wide range of comorbid conditions, including diabetes mellitus, coronary heart disease (CHD), gall bladder disease, hypertension, osteoarthritis, and certain cancers. Studies in Kuwait and other Gulf States indicate that obesity is prevalent and may be increasing. Previous studies in Kuwait have mostly focused on the epidemiology of overweight and obesity in children, adolescents, and young adults. Relatively less is known about the prevalence of overweight and obesity and its correlates in older adults for whom obesity may be more closely related to CHD risk. The purpose of this study was to examine the prevalence of overweight and obesity in 9755 adult men and women and to determine the relationship of weight to other risk factors for chronic disease. For the first time we examine a sample of older Kuwaitis to explore the relationship between high BMI, hypercholesterolemia and hyperglycemia. One-third of adult Kuwaitis are obese (BMI > 30 kg/m²), 4.7% of Kuwaiti females have severe obesity (BMI >40 kg/m²). BMI, cholesterol, and glucose values increase with age across the life span. Older Kuwaitis have a greater constellation of risk factors for chronic diseases. The results of a multiple linear regression model in which cholesterol values were studied, controlling for age, BMI, blood glucose, and sex revealed that age, BMI and sex were significant predictors of cholesterol values. These results indicate that actions to reduce obesity, hypercholesterolemia, and hyperglycemia are needed.     

不同体重指数和腰围水平与其他心血管病危险因素聚集的关系

目的探讨不同体重指数(BMI)和腰围水平对人群中其他心血管病危险因素聚集的影响.方法将1992～1994年和1998年在我国不同地区中年人群中进行的2次心血管病危险因素调查资料合并共30 561人,比较不同BMI和腰围分组的研究对象其他心血管病危险因素聚集率和聚集的相对危险,其中危险因素聚集定义为同一研究对象具有高血压、高血清总胆固醇、低高密度脂蛋白胆固醇或空腹血糖异常之中的任意2项或2项以上者.结果随着BMI和(或)腰围的增加,人群其他心血管病危险因素的聚集率呈明显上升趋势, 按BMI分层各组中,男女两性腰围与其他心血管病危险因素的聚集率均呈明显的线性上升趋势,同样在不同的腰围分组中,BMI均与其他心血管病危险因素的聚集率呈明显的线性趋势.男性和女性年龄调整心血管病危险因素聚集率在BMI<24 kg/m2、腰围(男/女)<85/80 cm组分别为11.1%和10.4%,BMI<24 kg/m2、腰围(男/女)85～95.9/80～89.9 cm组分别为24.2%和16.9%, BMI 24.0～27.9 kg/m2、腰围(男/女)<85/80 cm组分别为24.0%和17.0%,BMI 24～27.9 kg/m2、腰围(男/女)85～95.9 /80～89.9 cm组分别为34.3%和24.0%. BMI 24.0～27.9 kg/m2、腰围(男/女)≥95/90 cm组分别为40.8%和29.6%,BMI≥28 kg/m2、腰围(男/女)85～95.9/80～89.9 cm组分别为44.2%和29.9%,BMI≥28 kg/m2、腰围(男/女)≥95/90 cm组分别为54.7%和35.4%.结论 BMI和腰围水平均与其他心血管病危险因素的聚集有独立的正相关性.保持BMI和腰围均在正常范围对心血管健康是很重要的.     

Prevalence of coronary risk factors in healthy adult Kuwaitis

Obesity has been shown to be a serious health risk and is associated with a wide range of comorbid conditions, including diabetes mellitus, coronary heart disease (CHD), gall bladder disease, hypertension, osteoarthritis, and certain cancers. Studies in Kuwait and other Gulf States indicate that obesity is prevalent and may be increasing. Previous studies in Kuwait have mostly focused on the epidemiology of overweight and obesity in children, adolescents, and young adults. Relatively less is known about the prevalence of overweight and obesity and its correlates in older adults for whom obesity may be more closely related to CHD risk. The purpose of this study was to examine the prevalence of overweight and obesity in 9755 adult men and women and to determine the relationship of weight to other risk factors for chronic disease. For the first time we examine a sample of older Kuwaitis to explore the relationship between high BMI, hypercholesterolemia and hyperglycemia. One-third of adult Kuwaitis are obese (BMI > 30 kg/m2), 4.7% of Kuwaiti females have severe obesity (BMI > 40 kg/m2). BMI, cholesterol, and glucose values increase with age across the life span. Older Kuwaitis have a greater constellation of risk factors for chronic diseases. The results of a multiple linear regression model in which cholesterol values were studied, controlling for age, BMI, blood glucose, and sex revealed that age, BMI and sex were significant predictors of cholesterol values. These results indicate that actions to reduce obesity, hypercholesterolemia, and hyperglycemia are needed.     

Usual dietary isoflavone intake is associated with cardiovascular disease risk factors in postmenopausal women

Intervention data suggest a cardioprotective role for supplemental isoflavones; however, few studies have examined the cardiovascular disease (CVD) benefit of usual dietary isoflavone intake. This cross-sectional study examined the association between usual dietary isoflavone intake and CVD risk factors, including lipids and lipoproteins, body mass index (BMI) and fat distribution, blood pressure, glucose and insulin. Subjects were postmenopausal women (n = 208) aged 45-74 y, who attended screening and baseline visits for a randomized, double-blind, placebo-controlled trial examining the effects of isoflavone use. At screening, total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol were measured, and demographic, behavioral and menopausal characteristics were assessed. One month later, dietary intake over the past year was assessed with a standardized questionnaire. Anthropometric measurements and blood pressure were obtained, and a 75-g oral glucose tolerance test was administered. Isoflavone consumption did not vary by age, exercise, smoking, education or years postmenopausal. Women with high genistein intake had a significantly lower BMI (P-trend = 0.05), waist circumference (P-trend = 0.05) and fasting insulin (P-trend = 0.07) than those with no daily genistein consumption. In adjusted analyses, genistein, daidzein and total isoflavone intake were each positively associated with HDL cholesterol (P = 0.05) and inversely associated with postchallenge insulin (P = 0.05). These data suggest a protective role for dietary soy intake against CVD in postmenopausal women.     

Application of obesity treatment algorithms to Canadian adults

OBJECTIVE: The purpose of this study was to apply obesity treatment algorithms to a representative sample of Canadians to determine their potential impact on the population. DESIGN: The Canadian Heart Health Surveys (1986-1992) were used to describe the prevalence of adults (18-64 y) that would be eligible for weight loss treatment according to the US NIH algorithm, which uses body mass index (BMI), waist circumference (WC), and the presence of two or more cardiovascular disease (CVD) risk factors. Similar algorithms based on CVD risk factors and a single measure of either BMI or WC alone were also evaluated. RESULTS: Using the NIH algorithm, 24% of Canadians (28% men, 19% women) would be identified for weight loss treatment. Virtually, all subjects received the same treatment recommendations when using BMI and CVD risk factors only, while 22% (23% men, 21% women) would meet the criteria for treatment using WC and CVD risk factors only. CONCLUSIONS: Approximately one in four Canadians would be eligible for weight loss treatment using the NIH obesity treatment algorithm. However, the algorithm may be improved through the incorporation of more sensitive WC thresholds.