Search

Background: Creation of a hypertension risk stratification model and development of an algorithm to detect hypertension in teenagers. Methods: The study group consisted of 690 middle and high school students, aged 15–17 years, from the metropolitan area of Warsaw, Poland. Information concerning family history and presence of risk factors for cardiovascular disease was gathered. Three-time blood pressure measurements were taken during at least two separate visits, which were at least a week apart, using the auscultatory method, according to standard procedures. Anthropometric measurements included: body weight, height, arm, hip and abdominal circumference, skin-fold thickness measured on the rear surface of an arm, below the inferior angle of the scapula and at the belly. Following indexes were determined: body mass index (BMI), waist to hip ratio (WHR), waist to height ratio (WHtR), hip to height ratio. Results: A logistic regression model, describing the risk of hypertension in adolescents aged 15–17 was invented. π (x)=e^(g (x))/(1+e^(g (x)) ) where: g (x) = –0.097 × height + 0.085 × weight + 7.764 × WHR + 1.312 × hypertens_1(=yes). Hypertens_1 means presence of hypertension among members of the closest family.The formula was created, allowing the pre-selection of adolescents at risk of hypertension during screening. Next an algorithm for the detection of hypertension for practical use was proposed. Conclusions: Body weight, WHR and incidence of hypertension in the family are the strongest predictors of hypertension in teenagers. Proposed screening algorithm can be a useful tool for selecting teenagers at risk of hypertension and in need of specialized diagnostics and care.

Objective To determine whether an apparent association between hand osteoarthritis (OA) and adiposity is explained by the presence of OA at other joint sites. Methods Data from the Canadian Longitudinal Study on Aging, first cycle, Comprehensive Cohort. Respondents aged 45-85 years (n=18,279) were asked separate questions about doctor-diagnosed OA in the hand, hip, or knee. Multinomial logistic regression was used to investigate the relationship between all combinations of hand, hip, and knee OA and body mass index (BMI) and waist to height ratio (WHtR). Results OA was reported by 34.6% of respondents, 28.0% with OA at >1 joint site. Hand OA was not significantly associated with BMI after accounting for OA at other joint sites, with similar findings for WHtR. All joint site combinations containing the knee were strongly associated with BMI, with odds ratios (ORs) ranging from OR 2.92 (95% CI: 2.53,3.37) for knee OA only with obesity class I to OR 9.98 (95% CI: 7.12,13.88) for multi-joint knee, hip, hand OA with obesity class II/III. BMI distributions including knee OA were broader and shifted to higher BMI levels than those for hand or hip OA. Conclusions Apparent associations between hand OA and BMI may be explained by concurrent OA at other joint sites. Recognizing that OA is a multi-joint disease is crucial for studies of the associations of adiposity with OA in a particular joint, especially the hand. The association between knee OA and BMI appears to be distinct from those for OA at other joint sites.

Background Obesity is associated with reduced postoperative mortality among patients undergoing cardiovascular surgery. However, body mass index cannot differentiate abdominal fat composition. This study evaluated the relationships between total abdominal, subcutaneous, and visceral fat composition and postoperative mortality in East Asian patients undergoing cardiovascular surgery. Methods Adult patients who underwent cardiovascular surgery between October 2004 and December 2016 were retrospectively included. Total, subcutaneous, and visceral fat areas were measured from cross-sectional computed tomography images. The relationships between each fat composition and mortality were evaluated. Results In all, 3661 patients were analyzed, and overall mortality was 19.9% (729 died) during the 4.6-year median follow-up period. The risks of all-cause and cardiac-cause mortality decreased as subcutaneous fat composition increased (adjusted hazard ratio 0.997; 95% confidence interval, 0.994 to 1.000; and adjusted hazard ratio 0.994; 95% confidence interval, 0.989 to 0.999; P = .02 and P = .01, respectively). No association was detected between the total and visceral fat area and mortality. Conclusions Reduced abdominal subcutaneous fat, but not the total or visceral fat composition, was associated with higher all-cause and cardiac-cause mortality after cardiovascular surgery in East Asian patients, consisting mainly of normal weight or overweight patients.

Background: Cardiometabolic Index (CMI) was associated with several risk factors for stroke; however, few studies assessed the role of CMI in stroke risk. Objective: This study aimed to assess the association between CMI and stroke in a population- based cross-sectional study. Methods: This study included 4445 general residents aged ≥40 years selected by multistage stratified random cluster sampling. CMI was calculated as the product of the ratio of waist circumference to height (WHtR) and the ratio of triglyceride levels to high-density lipoprotein cholesterol levels (TG/HDL-C). Participants were categorized according to CMI quartiles: quartile 1 (Q1), quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4). Multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used to assess the association between CMI and stroke. Results: A total of 4052 participants were included in the study, with an overall stroke prevalence of 7.2%. The prevalence of stroke increased with CMI quartiles, ranging from 4.4% to 9.2% (p for trend Conclusion: Although there was a strong and independent association between CMI and stroke in the general population, CMI had limited discriminating ability for stroke. Thus, new parameters should be developed.

Background Few studies have been conducted on the associations of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with cognitive impairment among Chinese older adults through a prospective design. Objective This study was aimed to evaluate the associations of BMI, WC, and WHtR with cognitive impairment. Methods We included participants aged 65 years and older in 2014 at baseline and 2018 follow-up surveys of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). BMI, WC, and WHtR were calculated from measured weight, height, and waist circumference. Mini-Mental State Examination was utilized to assess cognitive impairment. Modified Poisson regression was used for calculating prevalence ratios, risk ratios, and 95% confidence intervals. Results A total of 5156 participants were included in 2014 at baseline. The prevalence of cognitive impairment was 42.5%, 26.7%, and 21.2% in underweight, normal-weight, and overweight/obesity participants defined by BMI categories, respectively, and 24.1% and 26.8% in central obesity participants defined by WC and WHtR cutoffs, respectively. Prospectively, participants with underweight were more likely to suffer from cognitive impairment (RR = 1.258, 95% CI: [1.016, 1.559]), but no risk was found among participants with overweight/obesity after adjustment. Regardless of whether covariates were adjusted or not, no effect on cognitive impairment was found in participants with WC and WHtR groups in the follow-up survey. Conclusions Underweight may be a significant risk factor for the cognitive impairment of Chinese older adults. Weight management programs targeting older adults should attach importance to achieving and maintaining optimal body weight and improving cognitive function.

Background: Body mass index (BMI) and the waist-to-height ratio (WHtR) are widely used anthropometric indices of obesity to predict cardiovascular risks. However, the usefulness of combining WHtR and BMI values to predict hypertension risk by sex has not been well elucidated. Methods and Results: This cohort study enrolled 45,921 participants (mean [±SD] age 53.8±10.5 years; 47.0% men) without hypertension from among those undergoing annual health checkups. Participants were divided into 4 categories based on median BMI and WHtR values, and the 5-year incidence of hypertension was assessed for both sexes using logistic regression analysis. Mean (±SD) BMI and WHtR values were 23.5±3.1 kg/m2 and 0.50±0.05, respectively, in men and 22.4±3.3 kg/m2 and 0.53±0.06, respectively, in women. Among the women, those with high BMI and low WHtR had an increased risk of hypertension compared with those with low BMI and low WHtR (odds ratio [OR] 1.37, P

Background Obesity is one of the most challenging clinical syndromes associated with deleterious health problems. Waist-to-height ratio (WHtR), a newer index for abdominal fat assessment, can be a superior tool in the evaluation of cardiometabolic risk. This study aimed to determine the relation between WHtR and lipid cardiovascular risk ratios and insulin resistance (IR) in children and adolescents with exogenous obesity. Results This analytical cross-sectional study included 80 children and adolescents with exogenous obesity, compared to 80 age- and sex-matched healthy non-overweight non-obese controls. Fasting lipid profile (total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL)), fasting insulin, and fasting blood glucose were done and lipoprotein risk ratios were calculated; TC/HDL, LDL/HDL, non-HDL/HDL, and TG/HDL). In addition, homeostatic model assessment for IR (HOMA IR), triglyceride glucose index (TyG), TyG-BMI, and TyG-WC were calculated. The study group included 55 (34.4%) males and 105 (65.6%) females with a mean age of 13.6 ± 2.22 years. Obese group had significantly higher TC, TG, LDL, non-HDL, LDL/HDL, TC/HDL, non-HDL/HDL, and TG/HDL, with significantly lower HDL. In addition, they had significantly higher FBG, HOMA IR, TyG, TyG-BMI, and TyG-WC indices compared to the control group. There were statistically significant correlations between WHtR and lipid profile, lipid risk ratios and indices of IR. WHtR was found to be an independent predictor of IR by linear regression analysis. Conclusion WHtR can be an excellent, easy, and reliable clinical predictor for cardiovascular risk and IR in children and adolescents with exogenous obesity.

To verify the multiple relations of physical education participation, school grade, age, and sex with longitudinal cardiorespiratory fitness changes in children and to identify if there is a mediator role of longitudinal body composition changes in these relations. Methodology: This is a longitudinal study, carried out from March to November of 2019, with children from 6 to 12 years old, 150 boys and 80 girls. Children were classified according to a cut point of 70% of participation in physical education classes (>70%= High PE x

Background Non-alcoholic fatty liver disease (NAFLD) has been entitled as metabolic-dysfunction associated fatty liver disease (MAFLD). Therefore anthropometric indicators of adiposity may provide a non-invasive predictive and diagnostic tool for this disease. This study intended to validate and compare the MAFLD predictive and diagnostic capability of eight anthropometric indicators. Methods The study involved a population-based retrospective cross-sectional design. The Fangchenggang area male health and examination survey (FAMHES) was used to collect data of eight anthropometric indicators, involving body mass index (BMI), waist-to-height ratio (WHtR), waist-hip ratio (WHR), body adiposity index (BAI), cardiometabolic index (CMI), lipid accumulation product (LAP), visceral adiposity index (VAI), and abdominal volume index (AVI). Receiver operating characteristics (ROC) curves and the respective areas under the curves (AUCs) were utilized to compare the diagnostic capacity of each indicator for MAFLD and to determine the optimal cutoff points. Binary logistic regression analysis was applied to identify the odds ratios (OR) with 95% confidence intervals (95% CI) for all anthropometric indicators and MAFLD. The Spearman rank correlation coefficients of anthropometric indicators, sex hormones, and MAFLD were also calculated. Results All selected anthropometric indicators were significantly associated with MAFLD (P Conclusion All anthropometric indicators were associated with MAFLD. WHtR was identified as the strongest predictor of MAFLD in young Chinese males, followed by LAP and AVI. The strongest association was found between LAP and sex hormones.

Background Handful studies report the prevalence of cardiovascular disease (CVD) risk factors among medical students from India and none from the eastern part of the country. Aim To estimate the prevalence of risk factors of CVD and their correlation with CVD risk ratio among the MBBS students from eastern India. Methods 433 students were studied. International Physical Activity Questionnaire-long form was used for assessment of physical activity and Perceived Stress Scale (PSS) to elicit psychological stress levels. Waist-to-height ratio (WHtR) was calculated. Total cholesterol to high-density lipoprotein ratio was calculated as the CVD risk ratio. Results 39.3% were women and 68.6% of the subjects were in junior classes. 22.4% subjects had high PSS while 30% performed low physical activity. Tobacco and alcohol intake was prevalent in 29.3% and 21.0% respectively. High CVD risk ratio was found in 14.3%. Most risk factors were more prevalent among juniors except diabetes. Among the non-overweight and non-obese subjects there was a significant positive correlation between WHtR and CVD risk score (R = 0.33, p F(7, 425) = 296.085), of which LDL (β = 0.755) contributed the most. Conclusions High prevalence of different modifiable CVD risk factors revealed among the subjects in this study is concerning. WHtR appears promising as an independent early predictor of CVD risk in Indian population. A dedicated CVD risk assessment tool for the young population is necessary.

Introduction The prevalence of type 2 diabetes mellitus (T2DM) is increasing among young people worldwide. The American Diabetes Association has defined the risk factors that are associated with this increased risk for developing T2DM in youths. Objective To explore school children at high-risk for T2DM in Jordan. Materials and methods A descriptive cross-sectional study was conducted. The children were 10–14.9 years old. Weight, height, and waist circumference were measured, and the body mass index Z score (BMI) was determined. The waist to height ratio (WHtR) was calculated. Blood pressure was measured and three childs risk factors were identified. Results Eight hundred and seventy-one schoolchildren were screened; 26.0% were overweight and 19.3% were obese. The most common risk factor among overweight and obese children, accounting for 80.4%, was a positive family history of type 2 diabetes mellitus in first- or second-degree relatives. Children born to mothers with diabetes or gestational diabetes mellitus during the child's gestation represented 17.3%, and around 26.8% were found to have hypertension (stage 1 or 2). In relation to the risk factors, 12.6% presented no risk factors; 54.0% had at least one factor; 29.1% two risk factors and 4.3% had three risk factors. Conclusion Risk factors for T2DM are very common. Around 54% had one risk factor. Strategies aimed at reducing risk factors for T2DM, especially obesity, among Jordanian school children are urgently needed.

This study aimed to assess the performance of waist-to-height ratio (WHtR) in the prediction of metabolic syndrome and to determine the appropriate cutoff value in Thai adolescents. Demographic data, blood pressure, fasting blood glucose, and lipid profile were obtained from the Thai National Health Examination Survey V database. The performances of WHtR, waist circumference, body mass index (BMI), and BMI z-score were analyzed by the receiver operating characteristics. Among 2644 adolescents, metabolic syndrome was identified in 4.27%. The areas under the receiver operating characteristic curves of WHtR, waist circumference, BMI, and BMI z-score were comparable (0.924-0.960). Performance of WHtR was more constant across age groups compared with other parameters. Using the cutoff value of WHtR at 0.5 resulted in the sensitivity and specificity of 98.5%/83.4% and 88.9%/86.0% in males and females, respectively. In conclusion, the cutoff value of WHtR at 0.5 provided good sensitivity and specificity for identifying metabolic syndrome in both genders. However, the other clinical risk factors or more definite scores should be considered when further assessment.

To compare the association between waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body mass index (BMI), and percentage of body fat (PBF) measured by dual energy X-ray absorptiometry (DXA) method in children and adolescents of Vietnam. This cross-sectional study included 153 children and adolescents aged 6–18 y old in Ho Chi Minh City, Vietnam. Correlations between indicators were determined using Pearson correlation coefficient (r). Linear regression was carried out with PBF as dependent variable to test the further association of potential indicators. The strongest correlation was found between PBF and WHtR in all pubertal stages (0.712; 0.556; 0.638 in male; 0.635; 0.799; 0.611 in female, respectively). The regression analysis indicated that WHtR was the most effective estimator of PBF ( $${{R}}_{{adj}}^{2}$$ = 0.69, RMSE = 4.54 for male; $${{R}}_{{adj}}^{2}$$ = 0.50, RMSE = 4.34 for female) in the model including pubertal stage variable for each gender. The results support the use of WHtR as an effective indicator for detecting adiposity in Vietnamese children and adolescents.

Background. The purpose of the study was to assess the presence of excess body weight, abdominal obesity (AO), and type 2 diabetes mellitus (DM) in oncological diseases in women of young and middle age. Materials and methods. 32 outpatient women aged 31 to 59 years with a verified oncological disease were examined. Standard clinical methods of investigation, statistical processing of results by nonparametric statistics were used. Results. Cervical cancer was verified in 24 (75.0 %) persons, breast adenocarcinoma — in 5 (15.6 %), rectal cancer — in 3 (9.4 %) patients. Elevated body mass index was detected in 24 (75.0 %) women: excess body weight — in 11 (34.4%), AO stage I — in 8 (25.0%), stage II — in 5 persons (15.6 %). Overweight or AO were detected in 30 (93.8 %) patients according to waist-to-height ratio. Type 2 DM was detected only in 2 patients (6.3 %). A heredity in oncopathology was recorded in half of women, of them for AO — in 8 (25.0 %), for type 2 DM — in 5 (15.6 %) patients. A direct correlation was established between heredity in oncological disease and body weight (r = 0.62, p < 0.01), waist circumference (r = 0.61, p

[Purpose] Exercise is a key factor in preventing obesity and metabolic syndrome. Sumo wrestlers increase their body size from childhood for athletic advantage; however, the risk of metabolic syndrome in junior sumo wrestlers is undetermined. Preventive measures against pediatric obesity should be initiated during childhood to prevent obesity in adulthood, considering its high global incidence. We comparatively evaluated the risk factors for metabolic syndrome in junior sumo wrestlers and children with obesity.[Methods] We enrolled 70 male children (age 9–17 years [sumo group, n = 14] and 9–14 years [other sports and non-exercise groups, n = 28 each]) and evaluated their anthropometric parameters (height, weight, body mass index z-score, obesity rate, waist circumference, waist to height ratio) and hematological parameters (total, low-density, high-density, and non-high-density lipoprotein-cholesterol; triglycerides; plasma glucose, and glycated hemoglobin levels).[Results] The BMI z-score, obesity rate, waist circumference (p < 0.05, along with the non-exercise group), and systolic blood pressure were significantly higher and the high-density cholesterol level was lower in the sumo group than in the other sports group (p < 0.05). The waist to height ratio was significantly higher in the non-exercise group than in the other sports group (p < 0.05). No significant difference was found in other blood lipid, plasma glucose (significantly lower level than the reference range in the sumo group, p < 0.05), and glycated hemoglobin (within the reference range in all groups) levels among the three groups.[Conclusion] Junior sumo wrestlers had a larger body size and higher blood pressure than children with obesity who exercised regularly. This provides direction for future research into targeted preventive interventions against metabolic syndrome for junior sumo wrestlers with large body size.

Although the dichotomous classification of metabolic syndrome (MS) enables the classification of individuals as MS-free or presenting MS, it is inconvenient for assessing cardiometabolic risk in MS-free individuals. Continuous MS score allows for estimation of cardiometabolic burden even in MS-free subjects. We used the scores to estimate the proportion of MS-free subjects on high cardiometabolic risk. A total of 876 subjects (62% females) of Central European descent, aged 20–81 years, were included. International Diabetes Federation (IDF) criteria were employed to classify MS. Continuous scores were calculated. We used the receiver operating characteristics (ROC) analysis to estimate the cutoff value to determine the proportion of MS-free subjects on increased risk. Using the waist circumference, 38% of males and 23% of females presented MS. ROC area under the curves (90%–98%) showed an acceptable performance of both scores to classify the presence of MS. Up to 18% of MS-free males and up to 10% of females displayed continuous score ≥ the relevant cutoff point. The waist-to-height ratio performed similar results. Both continuous scores were proven credible for assessing cardiometabolic risk in MS-free subjects. Clinically, this is important for earlier intervention. Despite minor differences between waist circumference and waist-to-height ratio, it would be appropriate to objectify it using reference population. Novelty: The first study using Z-MSS/siMSS (population-specific Z-score/continuous score of MS) to estimate cardiometabolic risk in Slovak adults. A proportion of MS-free Slovak adults is on high cardiometabolic risk. Difference between using waist circumference and the waist-to-height ratio does not seem to be major in our cohort.

BACKGROUND: Metabolic syndrome (MetS) is a cluster metabolic disorder that includes central obesity, insulin resistance, hypertension, and dyslipidemia, and is highly associated with an increased risk of developing non-communicable diseases (NCDs). This study aimed to compare the reliability of anthro-metabolic indices [visceral adiposity index (VAI), body roundness index (BRI), and a body shape index (BSI), body adiposity index (BAI), lipid accumulation product (LAP), waist to hip ratio, and waist to height ratio] in predicting MetS in Iranian older people. METHODS: This cross-sectional study was conducted based on the data of 2426 adults aged ≥60 years that participated in the second stage of the Bushehr Elderly Health (BEH) program, a population-based prospective cohort study being conducted in Bushehr, Iran. MetS was defined based on the revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. The receiver operating characteristic (ROC) curve analysis was used to assess predictive performance of anthro-metabolic indices and determine optimal cutoff values. Logistic regression analysis was applied to determine the associations between MetS and indices. RESULTS: 2426 subjects (48.1% men) with mean ± SD age of 69.34 ± 6.40 years were included in the study. According to ATP III criteria, 34.8% of men and 65.2% of women had MetS (P

Este estudo teve como objetivo analisar a capacidade preditiva e possíveis pontos de corte dos indicadores antropométricos na predição do baixo desempenho motor em ambos os sexos. Participaram do estudo 350 escolares (186 meninas e 164 meninos) com idades de oito a 10 anos. Fizeram parte da pesquisa três escolas, sendo duas escolas públicas e uma escola privada localizadas na cidade de Manaus-AM. Os indicadores antropométricos avaliados foram: Índice de Massa Corporal (IMC), Circunferência de Cintura (CC) e Razão Cintura Estatura (RCEst), e para avaliar as tarefas motoras foram utilizados os instrumentos Movement Assessment Battery for Children – Second Edition (MABC-2) e Körperkoordination Test für Kinder (KTK). A curva Receiver Operating Characteristic (ROC) foi utilizada para estimar a capacidade preditiva dos indicadores antropométricos (IMC, CC e RCEst), apontando o melhor ponto de corte para a predição do baixo desempenho motor. Foi possível verificar capacidade preditiva dos indicadores antropométricos no somatório dos quocientes motores no instrumento KTK na amostra geral (p

Obesity is a common disease among children, often accompanied by a lot of metabolic disease. Non-alcoholic fatty liver disease (NAFLD) is one of the most common complications of obesity among children and adolescents. Asprosin has been identified as a new adipokine that is closely associated with hepatic glucose metabolism. However, few data on asprosin in obese children with NAFLD are available. The present study focuses on the relationship between serum asprosin level and NAFLD in children with obesity. A total of 110 subjects (71 boys and 39 girls aged 6–18 years) were recruited from the Second Affiliated Hospital of Xi’an Jiaotong University: 36 obese children with NAFLD, 39 obese children without NAFLD and 35 lean controls. Anthropometric parameters and biochemical data were measured, and the concentrations of asprosin were detected by ELISA. The levels of serum asprosin were significantly higher in obese children, particularly those with NAFLD and were positively correlated with body mass index, waist to height ratio, fasting blood glucose, alanine aminotransferase and tumor necrosis factor-alpha. Furthermore, asprosin was independently associated with NAFLD in binary logistic regression analysis. Serum asprosin levels were elevated in obese children, especially in those with NAFLD, and were involved in the pathogenesis of NAFLD in children with obesity.

Background and aims Cardiometabolic 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 height0.5 (WHT.5R) and body mass index (BMI) with the risk of CM. Methods and results We 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 cm0.5 (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. Conclusion WHtR, 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.

OBJECTIVE This study aimed to evaluate whether a history of depression or self-injurious thoughts and behaviors predict elevated body mass index (BMI) and elevated waist-to-height ratio in preadolescents. METHODS Baseline data were evaluated from a large, nationally representative cohort study of 9- and 10-year-old children (unweighted n = 11,875), the Adolescent Brain and Cognitive Development study. RESULTS In the weighted sample, 10.6% of children had a history of depression, 7.0% had engaged in nonsuicidal self-injury, 13.1% had experienced suicidal ideation in their lifetime, and 1.1% had a history of attempted suicide. Among the children, 34.1% had an elevated BMI in the overweight or obese range and 31.9% had a waist-to-height ratio >0.5. In multivariate analyses, history of depression was associated with elevated BMI and waist-to-height ratio. Furthermore, interactions with sex were found; girls with a history of depression were more likely to have an elevated BMI (odds ratio = 1.47, 95% confidence interval = 1.24-1.74) and elevated waist-to-height ratio (odds ratio = 1.48, 95% confidence interval = 1.18-1.86) than girls without a history of depression, but no differences were observed between boys with and without a history of depression. Self-injurious thoughts and behaviors were not associated with elevated BMI or elevated waist-to-height. CONCLUSIONS In this study, 9- and 10-year-old girls with a history of depression were more likely to have an elevated BMI and elevated waist-to-height ratio than girls with no history of depression. These results provide important clinical context in caring for preadolescents with a history of depression.

BACKGROUND Growing evidence suggests that prenatal alcohol exposure (PAE) has the potential to impact on a wide range of physical outcomes in offspring, including metabolism and body composition, although the evidence to-date is primarily from preclinical studies. The current clinical study examined the association between heavy PAE and indirect measures of adiposity in adolescence. METHODS Analyses drew on data from the Longitudinal Study of Australian Children, a national prospective cohort of children and their families from birth to adolescence. Participants included children with heavy PAE (≥70 g/week; n = 46), measured via maternal self-report of alcohol use during pregnancy and a comparison group of children without any PAE (n = 782), frequency matched on sex, ethnicity and socio-economic position. Body mass index (BMI) z-scores, waist-to-height ratios and proportion overweight/obese were calculated from height, weight and waist circumference measured at age 12-13 years. Two (PAE) × two (sex) ANCOVA and logistic regression models were performed, controlling for matching variables, adolescent age, pubertal status and birthweight; maternal age at birth and smoking during pregnancy. RESULTS Female adolescents with heavy PAE during late pregnancy had significantly higher BMI z-scores (M = 0.75, SD = 0.69) and proportion overweight/obese (38.5%) than females not exposed to any prenatal alcohol (M = 0.29, SD = 1.07, P = 0.04; 23.8%, P = 0.03, respectively). There was no significant effect of heavy PAE on male adolescent BMI z-scores and proportion overweight/obese or adolescent waist-to-height ratios (all P > 0.05). CONCLUSIONS Heavy PAE had a sex-specific effect on measures of adiposity in early adolescence, with girls more likely to have increased BMI and overweight/obesity status. Further longitudinal follow-up of children exposed to PAE is required to confirm if maternal alcohol consumption is a risk factor for later life obesity.

Background: dyslipidemia and obesity are key independent modifiable risk factors for many non communicable chronic diseases. Patterns of association between these factors may help prevention and control. This study aims to assess the association between lipids profile and obesity among adults in Kingdom of Saudi Arabia and identify anthropometric predictors of dyslipidemia.Methods: data were collected and analyzed from a cross-sectional study using WHO STEPwise approach that included 4 990 Saudi adults aged 15- 64 years selected by stratified, multistage, cluster random sampling technique. Lipid profiles (cholesterol categories and triglycerides) were determined spectrophotometrically by colorimetric biochemical methods. Obesity was determined by calculation of body mass index (BMI=Kg/m2), waist and hip circumferences and ratio and waist to height ratio.Results: the overall prevalence of obesity ranged from 33.8 to 44.4 % and the overall dyslipidemia prevalence ranged from about 25 to 44% depending on type of dyslipidemia and anthropometrics used. Prevalence of dyslipidemia and mean concentration of lipids profile were generally significantly higher in obese than non obese. The indicator waist/height ratio was the significant predictor for all types of dyslipidemia and all levels of serum lipids.Conclusions: the prevalence dyslipidemia and obesity are high and they are positively associated. Waist/height ratio was the most important predictor of dyslipidemia among adults.

Data regarding the association of the waist-to-height ratio (WHtR) with hypertension (HTN) are conflicting. Moreover, little information is available on the association between WHtR and HTN subtypes. Therefore, we aimed to investigate the associations between WHtR and the prevalence of HTN and its subtypes in a Chinese population. In the cross-sectional analysis, 13,947 adults from the China Hypertension Survey study were analysed. We examined the relationship between WHtR and the prevalence of HTN and its subtypes (isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH) and systodiastolic hypertension (SDH)) using multivariate logistic regression analysis. A generalized additive model (GAM) and smooth curve fitting (penalized spline method) were also used. Overall, the mean WHtR was 0.50. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for HTN, ISH, IDH and SDH for each standard deviation (SD) increase in WHtR were 1.53 (1.45-1.61), 1.36 (1.28-1.44), 1.41 (1.20-1.65) and 1.47 (1.36-1.59), respectively. The fully adjusted smooth curve fitting revealed a linear association between WHtR and HTN, ISH, IDH, and SDH. Moreover, the positive associations between WHtR and HTN and its subtypes were more strong among younger adults (

Objectives: Obesity is one of the important risk factors for peripheral arterial disease (PAD). Ankle-brachial pressure index (ABPI) is a non-invasive test, which may be used for earlier detection of PAD. ABPI in healthy obese/overweight subjects has not been studied. In present study, we investigated correlation of adiposity indices with ABPI. We have also compared ABPI by three different methods in healthy obese/overweight subjects. Materials and Methods: Weight, height, body mass index (BMI), waist circumference, hip circumference (HC), waist height ratio, waist hip ratio, skin fold thickness, and body fat percentage were measured in 45 healthy overweight/obese males. Ankle and brachial pressures were measured by Doppler ultrasound based method. ABPI was calculated using high ankle pressure (ABPI-HIGH), mean ankle pressure (ABPI-MEAN), and low ankle pressure (ABPI-LOW) methods. Results: BMI and HC show positive significant correlation with ABPI-LOW (P = 0.028, P = 0.046, respectively). Significant difference was observed between ABPI-LOW and ABPI-HIGH (P = 0.003). ABPI-MEAN and ABPILOW were also significantly different (P < 0.001). Conclusion: There is a correlation of obesity indices with ABPI-LOW. ABPI-LOW methods could be more appropriate method and contrastingly HC may have direct correlation with PAD detection by ABPI in apparently healthy obese.

Backgrounds. The prevalence of diabetes has increased with the increase of obesity, and finding indicators to predict diabetes risk has become an urgent need. The purpose of this study is to compare the correlation between four anthropometric indices and the prevalence of diabetes. Methods. A total of 4052 participants aged 40 years and above were selected in Dehui City, Jilin Province, using a multistage stratified whole group sampling method. Face-to-face interviews and physical examinations were conducted. Multivariate logistic analysis was used. The values of BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were divided into quartiles (Q1: study participants ≥ 40 years of age, especially in females.

Objectives Postoperative atrial fibrillation (PoAF), an important clinical condition that can occur after coronary artery bypass graft (CABG) operations, may bring about cerebrovascular risks, prolong hospital stay and increase treatment costs. In this prospective study, we aimed to investigate the predictive value of HATCH score and waist/height ratio (WHR) values in revealing the development of PoAF after CABG operations. Methods Patients who underwent isolated CABG surgery with cardiopulmonary bypass between May 2019 and November 2019 were prospectively included in the study. Preoperative demographic characteristics, laboratory parameters, and operative parameters of the patients were recorded prospectively. Results A total of 255 patients were included in the study. Those who did not develop PoAF were included in Group 1 (N = 196, mean age = 58.9 ± 9.4 years), and those who did were included in Group 2 (n = 59, mean age = 61.1 ± 12 years). There were no statistically significant differences between the two groups in terms of age, gender, presence of hypertension and hyperlipidemia. Rates of chronic obstructive pulmonary disease and previous percutaneous coronary interventions, waist circumference, waist to height ratio and HATCH score values were significantly higher in Group 2 compared to Group 1 ( p values: 0.019, 0.034, 0.001

Title: Comparison of Peak Expiratory Flow Rate between Android and Gynoid Pattern Obesity in Females. Aim: To assess comparison of PEFR between Android and Gynoid Pattern Obesity in Females. Objectives: To assess Peak Expiratory Flow Rate in Android Pattern, Gynoid Pattern of Obesity in Females and compare Peak Expiratory Flow Rate between Android and Gynoid Pattern Obesity in Females. Methodology: 100 Female Obese Subjects with BMI> 30 in the Age Group between 20-40 yrs living a sedentary lifestyle were recruited with incidental sampling over the period of 1 year duration and allocated to Android (n = 50) and Gynoid (n = 50) groups on the basis of Adiposity Markers like BMI, Height, Weight, Waist Circumference (WC), Hip Circumference (HC), WHR - Waist Hip Ratio (WHR) and Waist to Height Ratio (WtHR). PEFR was recorded by taking 3 readings and the highest among them chosen. Results: Pearson correlation test and Linear Regression was done between PEFR & BMI, PEFR & WHR and PEFR & WHtR. Using an Unrelated t Test, results were found to be Significant (p < 0.05) between PEFR in Both the Groups. Conclusion: The study establishes that there is a difference in PEFR between Android and Gynoid Pattern of Obesity in Females and PEFR in Gynoid Pattern is 5% better than PEFR in the Android Pattern Obesity in Females.

Wen Ma,1,2,* Zhengwei Yan,2,* Wentao Wu,2 Daning Li,2 Shuai Zheng,3 Jun Lyu1– 3 1Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 2School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, People’s Republic of China; 3Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jun LyuClinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of ChinaTel +86-13379060167Email lyujun2020@jnu.edu.cnBackground: Obesity or underweight has been found to be associated with depression, but the relationship remains to be determined so that more precise prevention strategies can be implemented. Body mass index (BMI) and waist–height ratio (WHR) were used as indicators to study the dose–response relationship between depression and obesity or underweight.Methods: We obtained basic information and disease-related data for 13,975 adults from the National Health and Nutrition Examination Survey (NHANES) 2005– 2016 dataset. The depressive status was determined based on the PHQ-9 scale (> 4). Logistic regression was used to analyze the association and risk of BMI, WHTR and depressive status. Based on the results of logistic regression, the dose–response relationship between BMI, WHTR and depressive state was analyzed using restricted cubic splines (RCS).Results: The adjusted model showed that compared with the fourth quartile (Q4) of BMI, the odds ratios (ORs) of depression for Q1, Q2 and Q3 were 0.63 (0.56– 0.71), 0.61 (0.54– 0.68) and 0.74 (0.66– 0.82), and compared with the fourth quartile (Q4) of WHtR, the odds ratios (ORs) of depression for Q1, Q2 and Q3 were 0.55 (0.49– 0.62), 0.57 (0.51– 0.64) and 0.64 (0.57– 0.71), respectively. The restricted cubic spline regression depicted a U-shaped dose–response relationship between continuous changes of obesity indicators and the risk of depression (P1, P2 < 0.001). When the participants’ BMI reached approximately 25kg/m2 with the reference value of BMI was 18.5kg/m2, the risk of depression was minimized (OR=0.68, 95% Cl=0.56– 0.83). When the WHtR reached approximately 0.52 with the reference value of WHtR was 0.40, the risk of depression was minimized (OR=0.69, 95% Cl=0.54– 0.88).Conclusion: We found a significant U-shape correlation between BMI, WHtR and depression. People with slight overweight have the lowest risk of depression. However, according to the International Obesity standards, the population at these levels of weight may have an obesity-chronic disease risk, and this is not recommended.Keywords: BMI, waist-to-height ratio, depression, dose–response relationship

Background. The prevalence of obesity and metabolic syndrome (MetS) is increasing, worldwide. Using a simple, efficient and reliable tool for predicting MetS is an essential approach in preventive health programs. The aim of this study was to compare the different anthropometric indices in predicting metabolic syndrome in older adults. Methods. This cross-sectional study is a part of the Amirkola Health and Ageing cohort Project (2011–2016). Of total, 1,488 older people aged 60–92 years were entered to the study. Medical and personal information of participants were collected by a questionnaire. After measuring the height, weight, waist circumference, hip circumference and neck circumference, body mass index, waist to hip ratio, waist to height ratio, abdominal volume index and conicity index were calculated. Independent t-test, chi-square and ROC curve were used to analyze the data. Results. Based on ATPIII-2005 diagnostic criteria, the prevalence of metabolic syndrome was 71.57%.The prevalence in female was higher than male. All of examined anthropometric indices, except neck circumference (p = 0.10), showed a significant difference in people with MetS compared to the individuals without metabolic syndrome (p Conclusion. Waist to height ratio was the best predictor of MetS in older adults.

Background Obesity is well known as a risk factor for cardiovascular disease. We aimed to determine the performance of and the optimal cutoff values for obesity indices to discriminate the presence of metabolic abnormalities as a primary risk factor for cardiovascular diseases in a Health Examinees study (HEXA). Methods The current study analyzed 134,195 participants with complete anthropometric and laboratory information in a Health Examinees study, consisting of the Korean population aged 40 to 69 years. The presence of metabolic abnormality was defined as having at least one of the following: hypertension, hyperglycemia, or dyslipidemia. The area under the receiver operating characteristic curve (AUC) and 95% confidence intervals (CIs) were calculated for body mass index, waist to hip ratio, waist to height ratio, waist circumference, and conicity index. Results The AUC of metabolic abnormalities was the highest for waist-to-height ratio (AUC [95% CIs], 0.677 [0.672–0.683] among men; 0.691 [0.687–0.694] among women), and the lowest for the C index (0.616 [0.611–0.622] among men; 0.645 [0.641–0.649] among women) among both men and women. The optimal cutoff values were 24.3 kg/m2 for the body mass index, 0.887 for the waist-to-hip ratio, 0.499 for the waist-to-height ratio, 84.4 cm for waist circumference and 1.20 m3/2/kg1/2 for the conicity index among men, and 23.4 kg/m2 for the body mass index, 0.832 for the waist-to-hip ratio, 0.496 for the waist-to-height ratio, 77.0 cm for the waist circumference and 1.18 m3/2/kg1/2 for the conicity index among women. Conclusion The waist-to-height ratio is the best index to discriminate metabolic abnormalities among middle-aged Koreans. The optimal cutoff of obesity indices is lower than the international guidelines for obesity. It would be appropriate to use the indices for abdominal obesity rather than general obesity and to consider a lower level of body mass index and waist circumference than the current guidelines to determine obesity-related health problems in Koreans.

Background The prevalence of childhood obesity has been increasing worldwide. The connection between iron deficiency and obesity has received much research interest. The present study examined the profiles of anemia among school-aged children categorized by obesity-related index in Shandong, China. Methods A total of 20 172 children aged 7, 9, 12, and 14 years participated in the study, whose hemoglobin (Hb) concentration was measured by laboratory technicians. The prevalence rates of anemia among children within each subgroup categorized by body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) were determined. Results On the whole, 3.99% of boys and 6.68% of girls suffer from anemia. Disparities in the prevalence of anemia were observed between different subgroups categorized by BMI, WC and WHtR. For both boys and girls, the prevalence of anemia increased with the severity of thinness and obesity, suggesting that both severe thinness and severe obesity are associated with an elevated prevalence of anemia. Conclusion In the era of the obesity pandemic, obesity could potentially add to the burden of anemia, suggesting that obese children should not be ignored when establishing strategies targeted at preventing anemia.

Objective Nationally representative percentiles for waist circumference (WC), waist‐to‐height‐ratio (WHtR), and body mass index (BMI) are not available for children and adolescents in India. Methods Using LMS method, age‐ and gender‐specific reference growth charts were constructed for WC (n = 68,261), WHtR (n = 68,261), and BMI (n = 67,741) from children/adolescents aged 5–19 years who participated in a nationally representative survey. General obesity, indicating overall obesity, was defined as age–sex‐specific BMI z‐scores ≥ 95th percentile. Central obesity was defined in three ways: WC ≥ 90th percentile, WHtR ≥ 0.5, and both WC ≥ 90th percentile and WHtR ≥ 0.5. Findings WC and BMI percentiles for boys and girls are lower than those previously reported from India and several other countries. The BMI percentiles are lower than the WHO 2007 reference population. The prevalence of general obesity using India specific BMI centiles was 2.9% (95% CI: 2.6–3.2). The prevalence of central obesity was 6.1% (95% CI: 5.7–6.6) using WC ≥ 90th percentile, 5.3% (95% CI: 5.0–5.7) using WHtR ≥ 0.5, and 3.6% using both criteria. Three‐fourth of children with general obesity also had central obesity based on WC ≥ 90th. Conclusions Indian children are thinner than Caucasian and other Asian children, and the global WHO reference population. Using India specific reference, the prevalence of central obesity is higher than general obesity with a significant overlap between the two.

Objective The purpose of this study was to investigate the association of sodium intake with obesity in US children and adolescents. Methods Cross-sectional data were analyzed for 9,026 children and adolescents in the National Health and Nutrition Examination Survey (NHANES) 2009-2016. Usual sodium intake was estimated from 24-hour dietary recalls using a measurement error model. Logistic regression was used to assess the association of sodium intake with overweight/obesity, obesity, and central obesity (waist to height ratio [WtHR] ≥ 0.5; waist circumferences (WC) ≥ age- and sex-specific 90th percentile). Results Mean (SE) sodium intake was 3,010 (9) and 3,404 (20) mg/d for children and adolescents, respectively. The adjusted odds ratio (AOR) comparing Q4 versus Q1 (87.5th vs. 12.5th percentile of sodium intake) among children was 1.98 (95% CI: 1.19-3.28) for overweight/obesity, 2.20 (1.30-3.73) for obesity, 2.10 (1.12-3.95) for WC ≥ 90th percentile, and 1.68 (0.95-2.97) for WtHR ≥ 0.5, adjusting for demographics, energy, and sugar-sweetened beverage intake. Among adolescents, AOR was 1.81 (0.98-3.37) for overweight/obesity, 1.71 (0.82-3.56) for obesity, 1.62 (0.71-3.66) for WC ≥ 90th percentile, and 1.73 (0.85-3.50) for WtHR ≥ 0.5. Conclusions Sodium intake was positively associated with overweight/obesity, obesity, and central obesity among US children independent of energy and SSB intake, but the association did not reach significance among adolescents.

Purpose of review Cardiovascular disease (CVD) is a significant cause of morbidity and mortality in children with chronic kidney disease (CKD). The cause of CVD in children with CKD is multifactorial and there are new and emerging data regarding prevalence and risk factors for CVD in this population. Recent findings A number of recent publications from longitudinal cohort studies of children with CKD have greatly increased our knowledge about the prevalence and risk factors for CVD including hypertension, obesity and dyslipidaemia. Masked hypertension and isolated nocturnal hypertension both correlate with surrogate markers of CVD in children. Obesity and adiposity are associated with an increased risk of CVD. Markers other than BMI such as waist to height ratio and fat-free tissue to fat tissue ratio better correlate with the presence of CVD in children. Dyslipidaemia is extremely prevalent in the paediatric CKD population, but there is a lack of consensus on treatment. More data on the relationship between bone mineral disease and CVD continue to emerge including an association between hyperparathyroidism and isolated nocturnal hypertension. Summary Children with CKD have multiple potentially modifiable risk factors for CVD. Research focused on CVD outcomes in children is needed.

Objectives: Obesity is a known risk factor for diabetes mellitus. Multiple obesity indices are available to assess and classify obesity status, including Body Mass Index (BMI), Waist Circumference (WC), and Waist-Height Ratio (WHtR). The present research was conducted to assess these obesity indices for their usefulness in predicting hyperglycemia. Materials and Methods: BMI, WC, WHtR, and Random Capillary Blood Glucose (RCBG) levels were measured in total 188 adult volunteers from Varanasi, Uttar Pradesh, India. Pearson correlation, unpaired Student’s t-test, and Chi-square tests were applied to assess associations and difference of measured parameters among different categories. Receiver operating curve analysis was performed to find best obesity indices to predict hyperglycemia (RCBG ≥140 mg/dl) and to find optimal cut off values for prediction. Results: Age of subjects, WC and WHtR (but not BMI) were found significantly correlated with RCBG levels. WHtR classified highest number of subjects as obese, compared to BMI and WC. WHtR was also found to be the best obesity index to predict hyperglycemia in both male and female subjects. Conclusion: WHtR can be used as cost effective, non-invasive, and convenient obesity index for screening and prediction of hyperglycemia in apparently healthy adult subjects. Thus, identified subjects can further be advised to undergo blood glucose testing for the early detection of diabetes and prediabetes.