Neck Circumference,along with Other Anthropometric Indices,Has an Independent and Additional Contribution in Predicting Fatty Liver Disease

MethodsThis cross-sectional study comprised 4053 participants (1617 women and 2436 men, aged 20-88) recruited from the Health Examination Center in Guangzhou, China between May 2009 and April 2010. Anthropometric measurements were taken, abdominal ultrasonography was conducted and blood biochemical parameters were measured. Covariance, logistic regression and receiver operating characteristic curve analyses were employed.ResultsThe mean neck circumference was greater in subjects with fatty liver disease than those without the disease in both women and men after adjusting for age (P<0.001). Logistic regression analysis showed that the age-adjusted ORs (95% CI) of fatty liver disease for quartile 4 (vs. quartile 1) of neck circumference were 7.70 (4.95-11.99) for women and 12.42 (9.22-16.74) for men. After further adjusting for other anthropometric indices, both individually and combined, the corresponding ORs remained significant (all P-trends<0.05) but were attenuated to 1.94-2.53 for women and 1.45-2.08 for men. An additive interaction existed between neck circumference and the other anthropometric measures (all P<0.05). A high neck circumference value was associated with a much greater prevalence of fatty liver disease in participants with both high and normal BMI, waist circumference and waist-to-hip ratio values.ConclusionsNeck circumference was an independent predictor for fatty liver disease and provided an additional contribution when applied with other anthropometric measures.     

A Comparison of the Predictive Power of Anthropometric Indices for Hypertension and Hypotension Risk

Background and Aims

It is commonly accepted that body fat distribution is associated with hypertension, but the strongest anthropometric indicator of the risk of hypertension is still controversial. Furthermore, no studies on the association of hypotension with anthropometric indices have been reported. The objectives of the present study were to determine the best predictors of hypertension and hypotension among various anthropometric indices and to assess the use of combined indices as a method of improving the predictive power in adult Korean women and men.

Methods

For 12789 subjects 21–85 years of age, we assessed 41 anthropometric indices using statistical analyses and data mining techniques to determine their ability to discriminate between hypertension and normotension as well as between hypotension and normotension. We evaluated the predictive power of combined indices using two machine learning algorithms and two variable subset selection techniques.

Results

The best indicator for predicting hypertension was rib circumference in both women (p = <0.0001; OR = 1.813; AUC = 0.669) and men (p = <0.0001; OR = 1.601; AUC = 0.627); for hypotension, the strongest predictor was chest circumference in women (p = <0.0001; OR = 0.541; AUC = 0.657) and neck circumference in men (p = <0.0001; OR = 0.522; AUC = 0.672). In experiments using combined indices, the areas under the receiver operating characteristic curves (AUC) for the prediction of hypertension risk in women and men were 0.721 and 0.652, respectively, according to the logistic regression with wrapper-based variable selection; for hypotension, the corresponding values were 0.675 in women and 0.737 in men, according to the naïve Bayes with wrapper-based variable selection.

Conclusions

The best indicators of the risk of hypertension and the risk of hypotension may differ. The use of combined indices seems to slightly improve the predictive power for both hypertension and hypotension.     

Body mass index and relative handgrip strength are associated with the prevalence of hypertension in Korean elderly: Korean national fitness assessment in 2019

[Purpose]This study aimed to analyze the prevalence of hypertension according to the body mass index (BMI) and relative handgrip strength (RHGS) among elderly individuals in Korea. [Methods]We analyzed the data of 44,183 Korean elderly individuals over 65 years old (men: n = 15,798, age = 73.31 ± 5.04 years, women: n = 28,385, age = 72.14 ± 5.04 years) obtained from the Korean National Fitness Assessment in 2019. All the participants were categorized into three groups according to the BMI and RHGS; additionally, one-way ANOVA and logistic regression analysis were performed. [Results]Overweight (men: 1.16 odds ratio [OR] 1.06–1.26, 95% confidence interval [CI]; women: 1.15 OR, 1.07–1.23 95% CI) and obese (men: 1.54 OR, 1.42–1.66 95% CI; women: 1.44 OR, 1.36–1.53 95% CI) elderly individuals showed a higher prevalence of hypertension than elderly individuals with normal weight, after controlling for age. In men, a lower RHGS was associated with a higher prevalence of hypertension after controlling for age (weak RHGS: 1.09 OR, 1.00–1.17 95% CI; middle RHGS: 1.21 OR, 1.12–1.31 95% CI vs. strong RHGS). [Conclusion]A higher BMI was associated with the prevalence of hypertension in the elderly Korean population. In addition, a lower RHGS was associated with the prevalence of hypertension in elderly Korean men.     

Waist-to-Height Ratio and Cardiovascular Risk Factors among Chinese Adults in Beijing

Objectives

To examine whether waist-to-height ratio (WHtR) performed better than, body mass index (BMI) or waist circumference (WC) in relation to hypertension, diabetes, and dyslipidemia among Chinese adults in Beijing.

Methods

A total of 5720 adults (2371 men and 3349 nonpregnant women) aged 18 to 79 years were selected from the general population in a cross-sectional study. Data from a standardized questionnaire, physical examination, and blood sample were obtained.

Results

The area under curve (AUC) values for WHtR (0.661–0.773) were significantly higher than those for BMI for all outcomes in both sexes, except that WHtR and BMI had similar AUCs for dyslipidemia in men. The AUCs for WHtR were significantly higher than those for WC with respect to hypertension in both sexes, and to diabetes in women. AUCs for the relationships between anthropometric indices and the three outcomes were larger in women than in men, and tended to decrease with age. Optimal cutoffs for WHtR were 0.51–0.53 and 0.48–0.50 in men and women, respectively. With regard to the current Chinese criteria for BMI (≥24 kg/m²), WC (≥90 cm for men, and ≥85 cm for women), and the recommended cutoff of WHtR (≥0.5), WHtR yielded the greatest odds ratio for hypertension and diabetes in both sexes, and dyslipidemia in women. BMI had the highest odds ratio for dyslipidemia in men. The odds ratios of anthropometric indices for hypertension and diabetes, but not for dyslipidemia, were higher in women than in men. The association between anthropometric indices and the three outcomes decreased with age.

Conclusion

WHtR performed better than BMI and WC for the association with hypertension and diabetes. More studies should be conducted to explore the age differences in the relationships between obesity indices and cardiovascular risk factors.     

Prediction of Percentage Body Fat in Rural Thai Population Using Simple Anthropometric Measurements

Objective: To develop and validate sex‐specific equations for predicting percentage body fat (%BF) in rural Thai population, based on BMI and anthropometric measurements. Research Methods and Procedures: %BF (DXA; GE Lunar Corp., Madison, WI) was measured in 181 men and 255 women who were healthy and between 20 and 84 years old. Anthropometric measures such as weight (kilograms), height (centimeters), BMI (kilograms per meter squared), waist circumference (centimeters), hip circumference (centimeters), thickness at triceps skinfold (millimeters), biceps skinfold (millimeters), subscapular skinfold (millimeters), and suprailiac skinfold (millimeters) were also measured. The sample was randomly divided into a development group (98 men and 125 women) and a validation group (83 men and 130 women). Regression equations of %BF derived from the development group were then evaluated for accuracy in the validation group. Results: The equation for estimating %BF in men was: %BF(men) = 0.42 × subscapular skinfold + 0.62 × BMI ? 0.28 × biceps skinfold + 0.17 × waist circumference ? 18.47, and in women: %BF(women) = 0.42 × hip circumference + 0.17 × suprailiac skinfold + 0.46 × BMI ? 23.75. The coefficient of determination (R²) for both equations was 0.68. Without anthropometric variables, the predictive equation using BMI, age, and sex was: %BF = 1.65 × BMI + 0.06 × age ? 15.3 × sex ? 10.67 (where sex = 1 for men and sex = 0 for women), with R² = 0.83. When these equations were applied to the validation sample, the difference between measured and predicted %BF ranged between ±9%, and the positive predictive values were above 0.9. Discussion: These results suggest that simple, noninvasive, and inexpensive anthropometric variables may provide an accurate estimate of %BF and could potentially aid the diagnosis of obesity in rural Thais.     

Gender Differences in Anthropometric Predictors of Physical Performance in Older Adults

BackgroundBoth high body fat and low muscle mass have been associated with physical disability in older adults. However, men and women differ markedly in body composition; men generally have more absolute and relative lean muscle mass and less fat mass than women. It is not known how these anthropometric differences differentially affect physical ability in men and women.ObjectivesThis study examines differences in anthropometric predictors of physical performance in older women and men.MethodsParticipants were 470 older women and men 72.9 (7.9) years of age. Body composition was measured using dual-energy x-ray absorptiometry. Maximum leg strength and power were measured using a leg press. Muscle quality (MQ) was calculated as relative strength (leg press strength per kilogram of leg muscle mass). Gait speed and chair rise were used to assess mobility performance and functional strength.ResultsBody mass index (BMI), age, and MQ emerged as predictors (P < 0.05) of functional strength and mobility in men and women somewhat differently. After accounting for age and sample, leg MQ was related to chair rise time and gait speed in men but not women. BMI was related to gait speed in both men and women, but BMI was related to chair rise time only in women.ConclusionResults implicate the prioritized importance of healthy weight and muscle maintenance in older women and men for maintained physical functioning with aging.     

Night work is associated with glycemic levels and anthropometric alterations preceding diabetes: Baseline results from ELSA-Brasil

Night work has been suggested as a risk factor for diabetes. Individuals with high triglyceride levels, high LDL cholesterol, low HDL cholesterol and obesity, especially abdominal obesity, have a greater chance of developing diabetes. The aim of this study was to analyze glycemic levels, total cholesterol, HDL-C, LDL-C, triglycerides and the anthropometric alterations that precede diabetes, considering their possible association with nigh work among a non-diabetic population. Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) comprises of 15,105 civil servants (35–74 years old) at baseline (2008–2010). The following parameters were analyzed: serum cholesterol (total cholesterol, HDL-C, LDL-C), triglycerides and glucose drawn from 12-hour fasting blood sample, glycated hemoglobin and 2-hour plasma glucose obtained after a 75 g oral glucose tolerance test, BMI, hip and waist measurements using standard equipment and techniques. Participants with diabetes, retired workers and day workers with previous experience of night work were excluded. Generalized linear models, a gamma regression model with an identity link function, were performed to test the association of night work with metabolic and anthropometric variables. The study sample consisted of 3918 men and 4935 women; 305 (7.8%) and 379 (7.7%) of the participants were men and women who worked at night, respectively. Among the men, the exposure to night work was associated with an increase in BMI (b-value = 0.542; p = 0.032) and waist circumference (b-value = 1.66; p = 0.014). For women, increased fasting plasma glucose (b-value = 2.278; p < 0.001), glycated hemoglobin (b-value = 0.099, p < 0.001) and 2 hour plasma glucose (b-value = 5.479, p = 0.001) were associated with night work after adjustments. No significant associations between night work and triglycerides, LDL-C, HDL-C, total cholesterol levels or waist–hip ratio were found. The influences of night work on metabolic and anthropometric factors suggest night work as a potential risk factor for type 2 diabetes. Further studies are needed to investigate the inconclusive data on gender differences in the associations.     

Relationship between Body Mass Index and Percent Body Fat in Vietnamese: Implications for the Diagnosis of Obesity

BackgroundThe burden of obesity in Vietnam has not been well defined because there is a lack of reference data for percent body fat (PBF) in Asians. This study sought to define the relationship between PBF and body mass index (BMI) in the Vietnamese population.MethodsThe study was designed as a comparative cross-sectional investigation that involved 1217 individuals of Vietnamese background (862 women) aged 20 years and older (average age 47 yr) who were randomly selected from the general population in Ho Chi Minh City. Lean mass (LM) and fat mass (FM) were measured by DXA (Hologic QDR 4500). PBF was derived as FM over body weight.ResultsBased on BMI ≥30, the prevalence of obesity was 1.1% and 1.3% for men and women, respectively. The prevalence of overweight and obesity combined (BMI ≥25) was ~24% and ~19% in men and women, respectively. Based on the quadratic relationship between BMI and PBF, the approximate PBF corresponding to the BMI threshold of 30 (obese) was 30.5 in men and 41 in women. Using the criteria of PBF >30 in men and PBF >40 in women, approximately 15% of men and women were considered obese.ConclusionThese data suggest that body mass index underestimates the prevalence of obesity. We suggest that a PBF >30 in men or PBF >40 in women is used as criteria for the diagnosis of obesity in Vietnamese adults. Using these criteria, 15% of Vietnamese adults in Ho Chi Minh City was considered obese.     

Age variations in anthropometric and body composition characteristics and undernutrition among female Bathudis: a tribal population of Keonjhar District, Orissa, India

A cross-sectional study of 183 female Bathudis, a tribal population of the Keonjhar District, Orissa, India, was undertaken to investigate age variations in anthropometric and body composition characteristics and nutritional status. The subjects were categorized into three age groups: < or =30 years, 31-50 years, >50 years. Height, weight, circumferences and skinfolds data were collected. Body mass index (BMI) and several body composition variables and indices were derived using standard equations. The results revealed that there existed significant negative age variations for most of the anthropometric and body composition variables and indices. Correlation studies of age with these variables and indices revealed significant negative correlations. Linear regression analyses revealed that for all variables, age had a significant negative impact. Studies on the nutritional status of these women revealed that with increasing age, there was an increase in the frequency of undernutrition. In conclusion, this study demonstrated that among Bathudi women, age was significantly negatively related with anthropometric and body composition variables and indices. Moreover, with increasing age, the level of undernutrition increased.     

Prevalence of Dyslipidaemia and Associated Risk Factors in a Rural Population in South-Western Uganda: A Community Based Survey

BackgroundThe burden of dyslipidaemia is rising in many low income countries. However, there are few data on the prevalence of, or risk factors for, dyslipidaemia in Africa.MethodsIn 2011, we used the WHO Stepwise approach to collect cardiovascular risk data within a general population cohort in rural south-western Uganda. Dyslipidaemia was defined by high total cholesterol (TC) ≥ 5.2mmol/L or low high density lipoprotein cholesterol (HDL-C) <1 mmol/L in men, and <1.3 mmol/L in women. Logistic regression was used to explore correlates of dyslipidaemia.ResultsLow HDL-C prevalence was 71.3% and high TC was 6.0%. In multivariate analysis, factors independently associated with low HDL-C among both men and women were: decreasing age, tribe (prevalence highest among Rwandese tribe), lower education, alcohol consumption (comparing current drinkers to never drinkers: men adjusted (a)OR=0.44, 95%CI=0.35-0.55; women aOR=0.51, 95%CI=0.41-0.64), consuming <5 servings of fruit/vegetable per day, daily vigorous physical activity (comparing those with none vs those with 5 days a week: men aOR=0.83 95%CI=0.67-1.02; women aOR=0.76, 95%CI=0.55-0.99), blood pressure (comparing those with hypertension to those with normal blood pressure: men aOR=0.57, 95%CI=0.43-0.75; women aOR=0.69, 95%CI=0.52-0.93) and HIV infection (HIV infected without ART vs. HIV negative: men aOR=2.45, 95%CI=1.53-3.94; women aOR=1.88, 95%CI=1.19-2.97). The odds of low HDL-C was also higher among men with high BMI or HbA1c ≤6%, and women who were single or with abdominal obesity. Among both men and women, high TC was independently associated with increasing age, non-Rwandese tribe, high waist circumference (men aOR=5.70, 95%CI=1.97-16.49; women aOR=1.58, 95%CI=1.10-2.28), hypertension (men aOR=3.49, 95%CI=1.74-7.00; women aOR=1.47, 95%CI=0.96-2.23) and HbA1c >6% (men aOR=3.00, 95%CI=1.37-6.59; women aOR=2.74, 95%CI=1.77-4.27). The odds of high TC was also higher among married men, and women with higher education or high BMI.ConclusionLow HDL-C prevalence in this relatively young rural population is high whereas high TC prevalence is low. The consequences of dyslipidaemia in African populations remain unclear and prospective follow-up is required.     

Perceived Stress and Coping Strategies in Relation to Body Mass Index: Cross-Sectional Study of 12,045 Japanese Men and Women

BackgroundAccumulated evidence suggests a weak positive relationship between psychosocial stress and body mass index (BMI), but little is known about stress coping strategies and BMI.ObjectiveWe aimed to examine if perceived stress and coping strategies are related to BMI, with any of their mutual interactions on BMI.MethodsThis cross-sectional study included 5,063 men and 6,982 women aged 40-69 years. A self-administered questionnaire ascertained perceived stress and 5 items of coping strategies (emotion expression, emotional support seeking, positive reappraisal, problem solving, and disengagement). Analyses were performed by gender with adjustment for age, socioeconomic status, and lifestyle factors.ResultsNo significant associations were detected between perceived stress and BMI in either men (P_trend = 0.09) or women (P_trend = 0.58). In men, however, ‘disengagement’ showed an inverse association with BMI (P_trend < 0.001), and ‘positive reappraisal’ and ‘problem solving’ revealed a positive association with BMI (P_trend = 0.04 and 0.007, respectively) even after controlling for perceived stress. A possible interaction between perceived stress and ‘disengagement’ on BMI was found in men (P_interaction = 0.027); the inverse association between ‘disengagement’ and BMI was more evident in higher levels of stress (β = −0.13, P_trend = 0.21 in low; β = −0.22, P_trend = 0.01 in medium; and β = −0.24, P_trend = 0.06 in high). In men, ‘disengagement’ was inversely associated with overweight/obesity (odds ratio 0.79, 95% confidential interval 0.67-0.95), and “positive reappraisal” was positively associated with it (1.25, 1.02-1.54).ConclusionsCoping strategies may have an important role in developing overweight/obesity, particularly in men.     

Abdominal Adipose Tissue was Associated with Glomerular Hyperfiltration among Non- Diabetic and Normotensive Adults with a Normal Body Mass Index

Glomerular hyperfiltration is recognized as an early marker of progressive kidney dysfunction in the obese population. This study aimed to identify the relationship between glomerular hyperfiltration and body fat distribution measured by computed tomography (CT) in healthy Korean adults. The study population included individuals aged 20–64 years who went a routine health check-up including an abdominal CT scan. We selected 4,378 individuals without diabetes and hypertension. Glomerular filtration rate was estimated using the CKD-EPI equation, and glomerular hyperfiltration was defined as the highest quintile of glomerular filtration rate. Abdominal adipose tissue areas were measured at the level of the umbilicus using a 16-detector CT scanner, and the cross-sectional area was calculated using Rapidia 2.8 CT software. The prevalence of glomerular hyperfiltration increased significantly according to the subcutaneous adipose tissue area in men (OR = 1.74 (1.16–2.61), P for trend 0.016, for the comparisons of lowest vs. highest quartile) and visceral adipose tissue area in women (OR = 2.34 (1.46–3.75), P for trend < 0.001) in multivariate analysis. After stratification by body mass index (normal < 23 kg/m², overweight ≥ 23 kg/m²), male subjects with greater subcutaneous adipose tissue, even those in the normal BMI group, had a higher prevalence of glomerular hyperfiltration (OR = 2.11 (1.17–3.80), P for trend = 0.009). Among women, the significance of visceral adipose tissue area on glomerular hyperfiltration resulted from the normal BMI group (OR = 2.14 (1.31–3.49), P for trend = 0.002). After menopause, the odds ratio of the association of glomerular hyperfiltration with subcutaneous abdominal adipose tissue increased (OR = 2.96 (1.21–7.25), P for trend = 0.013). Subcutaneous adipose tissue areas and visceral adipose tissue areas are positively associated with glomerular hyperfiltration in healthy Korean adult men and women, respectively. In post-menopausal women, visceral adipose tissue area shows significant positive association with glomerular hyperfiltration as in men.     

Visceral fat, waist circumference, and BMI: impact of race/ethnicity

Objective: BMI and waist circumference are used to define risk from excess body fat. Limited data in women suggest that there may be racial/ethnic differences in visceral adipose tissue (VAT) at a given BMI or waist circumference. This study tested the hypothesis that racial/ethnic differences exist in both men and women in the relationship of anthropometric measures of body composition and computed tomography (CT)‐determined VAT or subcutaneous adipose tissue (SAT). Methods and Procedures: Subjects included 66 African American, 72 Hispanic, and 47 white men and women, aged ≥ 45. Waist circumference and BMI were measured using standard methods. Total abdominal and L4L5 VAT and SAT were measured using CT. Results: Among both men and women, groups did not differ in waist circumference or BMI. White men had greater L4L5 VAT than African‐American men, and both white and Hispanic men had greater total VAT than African‐American men. Among women, Hispanics and whites had greater L4L5 VAT than African Americans, and Hispanics had greater total VAT than African Americans. The slope of the linear relationship between BMI or waist circumference and VAT was lower in African Americans than in Hispanics and/or whites. Discussion: Middle‐aged and older African‐American men and women had lower VAT despite similar BMI and waist circumference measurements. Altered relationships between anthropometric measures and VAT may have implications for defining metabolic risk in different populations. Different waist circumference or BMI cutoff points may be necessary to adequately reflect risk in different racial/ethnic groups.     

Associations of Fat Distribution and Obesity with Hypertension in a Bi‐ethnic Population: The ARIC Study

Objective: To examine associations of hypertension with obesity and fat distribution among African American and white men and women. Research Methods and Procedures: The analysis sample included 15,063 African American and white men and women between the ages of 45 and 64 years who were participants in the 1987 through 1989 examination of the Atherosclerosis Risk in Communities Study (ARIC). Odds ratios and adjusted prevalences of hypertension were calculated across sexspecific quintiles of body mass index (BMI), waist‐to‐hip ratio (WHR), waist circumference, and waist‐to‐height ratio (waist/height) and adjusted for age, research center, smoking, education, physical activity, alcohol consumption, hormone replacement therapy, and menopausal status. Results: The prevalence of hypertension was higher among African Americans than whites. In the lowest quintile of BMI, 41% of African American women and 43% of African American men had hypertension compared with 14% of white women and 19% of white men. Elevated BMI, WHR, waist circumference, and waist/height were associated with increased odds of hypertension in African American and white men and women. In women, but not in men, there were significant interactions between ethnicity and the anthropometric variables studied here. The direction of the interaction indicated larger odds ratios for hypertension with increasing levels of anthropometric indices in white compared with African American women. Discussion: Obesity and abdominal fat preponderance were associated with increased prevalence of hypertension in African American and white men and women. Associations were similar among African American and white men, but obesity and fat patterning were less strongly associated with hypertension in African American than in white women.     

Association of Estimated Glomerular Filtration Rate with Hemoglobin Level in Korean Adults: The 2010–2012 Korea National Health and Nutrition Examination Survey

PurposeLittle is known about anemia in patients with early renal dysfunction. We aimed to investigate the association of hemoglobin level and anemia prevalence with estimated glomerular filtration rate (eGFR) decline using a nation-wide representative sample of the adult Korean population.MethodsIn total, 17,373 participants (7,296 men; weighted n = 18,330,187; mean age, 44.2±0.3 years; 9,886 women, weighted n = 18,317,454; mean age, 46.9±0.3 years) were included. eGFR was divided into 5 groups: Group 1, ≥105; Group 2, 90–104; 75–89; Group 4, 60–74; and Group 5, <60 mL/min/1.73m².ResultsThe weighted anemia prevalence rates were 2.6% in men and 12.8% in women. In men, the weighted hemoglobin level increased with a decrease in eGFR; this value peaked at an eGFR of 60–89 mL/min/1.73m² and decreased thereafter at an eGFR of <60 mL/min/1.73m² (15.19±0.03, 15.35±0.03, 15.53±0.03, 15.52±0.06, and 14.90±0.12 g/dL from Groups 1 to 5) after adjustment for age, college graduation, cancer history, current smoking, waist circumference, serum cholesterol level, serum triglyceride level, and diastolic blood pressure. In women, the weighted hemoglobin level increased with a decrease in eGFR; this value peaked with an eGFR of 75–89 mL/min/1.73m² and decreased thereafter (12.90±0.03, 13.08±0.02, 13.20±0.04, 13.14±0.05, and 12.47±0.11 g/dL from Groups 1 to 5) after adjustment for menstruation, pregnancy, estrogen replacement, and the above-mentioned variables. In both sexes, the weighted prevalence of anemia with an eGFR of 60–104 mL/min/1.73m² was significantly lower than that with an eGFR of ≥105 mL/min/1.73m² (men, 3.2±0.4%, 1.9±0.3%, 1.8±0.3%, 2.0±0.9%, and 18.1±3.1%; women, 14.0±0.8%, 11.2±0.7%, 10.5±1.0%, 13.2±1.6%, and 32.3±3.2% from Groups 1 to 5).ConclusionsWe noted a compensatory increase in the hemoglobin level with a minor decline in kidney function (in the range of eGFR ≥60 mL/min/1.73m²) prior to a marked decrease in hemoglobin level with severe renal dysfunction.     

The Relationship between Serum Ferritin Levels and Insulin Resistance in Pre- and Postmenopausal Korean Women: KNHANES 2007–2010

BackgroundSerum ferritin levels increase in postmenopausal women, and they are reported to be linked to major health problems. Here, we investigated the association between serum ferritin levels and insulin resistance (IR) in postmenopausal women.MethodsA total of 6632 healthy Korean women (4357 premenopausal and 2275 postmenopausal) who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) in 2007–2010 were enrolled in the study. Serum ferritin values were divided into six groups for the premenopausal and postmenopausal groups. IR and obesity indices were evaluated according to the six serum ferritin groups. Statistical analysis was carried out using SAS software, version 9.2 (SAS Institute Inc., Cary, NC, USA).ResultsThe association between the IR indices and ferritin groups had a higher level of statistical significance in the postmenopausal group than in the premenopausal group. In addition, for the postmenopausal group, the estimates increased significantly in the sixth ferritin group compared to those in the first ferritin group. However, the association between the obesity indices and ferritin levels was not significantly different between the premenopausal and postmenopausal groups.ConclusionElevated serum ferritin levels were associated with an increased risk of insulin resistance in postmenopausal women.     

Does Waist Circumference Add to the Predictive Power of the Body Mass Index for Coronary Risk?

Objectives: To examine the power of the combined measurements of body mass index (BMI) and waist circumference (WC) for the prediction of abnormality in coronary heart disease risk factors and to determine whether the additional measurement of WC is predictive in older men and women. Research Methods and Procedures: 1190 men and 751 women of the Baltimore Longitudinal Study of Aging were dichotomized into younger (<65 years) and older (65+ years) age groups. Coronary risk factors in the realms of glucose/insulin metabolism, blood pressure, and plasma lipids were assessed. The relationship of BMI and WC, singly and combined, to 10 risk factors for coronary heart disease was examined. Results: In younger and older men and women, BMI and WC are highly correlated (0.84 to 0.88). BMI and WC are also significantly correlated to all 10 coronary risk factors in younger men and women and to 8 of the 10 in the older men and women. Both partial correlation and logistic regression analyses revealed a modest but significant improvement in the prediction of coronary risk in younger men and women by WC after controlling for the level of BMI. There was no improvement in the older subjects. Discussion: WC adds only modestly to the prediction of coronary risk in younger subjects once BMI is known, and adds nothing to the production of risk in older subjects.     

Age-Dependent Influence of Gender on the Association Between Obesity and a Cluster of Cardiometabolic Risk Factors

BackgroundObesity is a main risk factor in metabolic syndrome. Gender is known to influence the risk of obesity and other cardiovascular risk factors. However, it remains to be determined whether there is a gender-specific difference in the relationship between obesity and accumulation of other cardiometabolic risk factors such as hypertension, dyslipidemia, and diabetes.ObjectiveThe aim of this study was to determine whether the association between obesity and a cluster of other cardiometabolic risk factors is modified by gender.MethodsThe subjects were 17,791 Japanese men and women who were divided into younger (35–40 years) and older (60–70 years) age groups. The relationships between obesity (body mass index [BMI] ≥25 kg/m² or waist-to-height ratio [WHtR] ≥0.5) and multiple cardiometabolic risk factors (≥2 of the risk factors of high blood pressure, dyslipidema, and hyperglycemia) were compared between men and women in each age group.ResultsIn the younger group, the crude odds ratios (ORs) for multiple cardiometabolic risk factors in obese versus nonobese subjects were significantly higher in women than in men (BMI: 6.23 [range, 5.53–7.02] in men vs 16.63 [range, 12.37–22.37] in women, P < 0.01; WHtR: 6.04 [range, 5.36–6.81] in men vs 9.77 [range, 7.14–13.37] in women, P < 0.01), whereas this difference was not found in the older group (BMI: 3.03 [range, 2.69–3.42] in men vs 2.92 [range, 2.33–3.67] in women P = 0.076; WHtR: 3.11 [range, 2.78–3.47] in men vs 2.50 [range, 2.02–3.09] in women, P < 0.05). On multivariate logistic regression analysis, the ORs for multiple cardiometabolic risk factors after adjusting for age, smoking, alcohol consumption, and regular exercise in subjects with versus subjects without a large waist circumference tended to be higher in women than in men in the younger group but not in the older group. The ORs of the interaction term consisting of gender and each adiposity index for multiple cardiometabolic risk factors were significantly higher than a reference level of 1.00 in the younger group (BMI: 2.68 [range, 1.95–3.69], P < 0.01; WHtR: 1.62 [range, 1.16–2.27], P < 0.01) but not in the older group (BMI: 0.95 [range, 0.74–1.23], P = 0.712; WHtR: 0.80 [range, 0.63–1.02], P = 0.066).ConclusionThe results suggest that the association between obesity and a cluster of cardiometabolic risk factors is stronger in women than in men, and this gender-specific difference exists in younger (35–40 years) but not in older (60–70 years) individuals.     

Evidence supporting nubility and reproductive value as the key to human female physical attractiveness

Selection should favor mating preferences that increase the chooser's reproductive success. Many previous studies have shown that the women men find most attractive in well-nourished populations have low body mass indices (BMIs) and small waist sizes combined with relatively large hips, resulting in low waist-hip ratios (WHRs). A frequently proposed explanation for these preferences is that such women may have enhanced health and fertility; but extensive evidence contradicts this health-and-fertility explanation. An alternative view is that men are attracted to signs of nubility and high reproductive value, i.e., by indicators of physical and sexual maturity in young women who have not been pregnant. Here we provide evidence in support of the view that a small waist size together with a low WHR and BMI is a strong and reliable sign of nubility. Using U.S. data from large national health surveys, we show that WHR, waist/thigh, waist/stature, and BMI are all lower in the age group (15-19) in which women reach physical and sexual maturity, after which all of these anthropometric measures increase. We also show that a smaller waist, in conjunction with relatively larger hips or thighs, is strongly associated with nulligravidity and with higher blood levels of docosahexaenoic acid (DHA), a fatty acid that is probably limiting for infant brain development. Thus, a woman with the small waist and relatively large hips that men find attractive is very likely to be nubile and nulliparous, with maximal bodily stores of key reproductive resources.     

Changes in body mass index and smoking habits have a different impact on hemoglobin concentration in men and women: A longitudinal follow-up of the tromsø study, 1994–2002

Background: Body mass index (BMI) and smoking have been positively associated with hemoglobin concentration, and both are risk factors for cardiovascular disease.Objective: The aim of this study was to assess whether there were sex differences in how changes in BMI and smoking habits influenced hemoglobin concentration.Methods: In 1994–95 and 2001–02, a longitudinal, population-based study was conducted in the municipality of Tromsø, in northern Norway. Inhabitants aged ≥25 years were invited to participate. Participants replied to a questionnaire regarding health, physical activity, coffee and alcohol consumption, and smoking habits. Blood samples were drawn to analyze hemoglobin concentration.All analyses were performed separately for each sex. Differences between 1994–95 and 2001–02 were examined with t or χ² (McNemar) tests for paired data. Cross-sectional comparisons were made using 2-sample t tests. Different models of univariate and multiple linear regression analyses were used to investigate the impact of the various variables on hemoglobin change.Results: Data from a total of 2105 men and 2945 women were examined. At baseline, mean age was 58.9 years for men (range, 25–78 years) and 57.8 years for women (range, 25–82 years); mean BMI was 26.1 kg/m² for men and 25.8 kg/m² for women. In men, hemoglobin decreased with age, on average from 147.5 to 145.1 g/L. In women, hemoglobin decreased from 135.6 to 134.7 g/L, but increased with increasing age up to 54 years, and thereafter decreased gradually. Mean BMI increased 0.8 kg/m² in men and 1.2 kg/m² in women. In total, 394 of 2057 men (19%) and 499 of 2889 women (17%) stopped smoking or smoked fewer cigarettes per day. In a univariate regression model, an increase of 1 kg/m² in BMI was associated with an increase in hemoglobin of 1.1 g/L (95% CI, 0.84 to 1.27) in men and 0.4 g/L (95% CI, 0.30 to 0.56) in women. In another univariate model, smoking cessation was associated with a decrease in hemoglobin of 1.9 g/L (95% CI, ?3.32 to ?0.56) in men and 1.7 g/L (95% CI, ?2.93 to ?0.56) in women. In men who smoked less and had a BMI increase of >2.5 kg/m², hemoglobin decreased 0.3 g/L. In contrast, hemoglobin decreased 3.4 g/L in men who smoked less and lost weight (P for trend, < 0.001 by changing BMI). Women who smoked less had a decrease in hemoglobin independent of BMI changes.Conclusions: The positive association between an increase in BMI and hemoglobin was stronger in men than in women. The effect of smoking reduction on hemoglobin was attenuated with increasing BMI in men, but not in women.