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1.
Objective : To determine the relative validity of specific bioelectrical impedance analysis (BIA) prediction equations and BMI as predictors of physiologically relevant general adiposity. Research Methods and Procedures : Subjects were >12, 000 men and women from the Third National Health and Nutrition Examination Survey population. We examined the correlations between BMI and percentage body fat based on 51 different predictive equations, blood pressure, and blood levels of glucose, high‐density lipoprotein cholesterol, and triglycerides, which are known to reflect adiposity, while controlling for other determinants of these physiological measures. Results : BMI consistently had one of the highest correlations across biological markers, and no BIA‐based measure was superior. Percent body fat estimated from BIA was minimally predictive of the physiological markers independent of BMI. Discussion : These results suggest that BIA is not superior to BMI as a predictor of overall adiposity in a general population.  相似文献   

2.
Objective: This study aims to examine the association between various measures of adiposity and all‐cause mortality in Swedish middle‐aged and older men and women and, additionally, to describe the influences of age and sex on these associations. Research Methods and Procedures: A prospective analysis was performed in a cohort of 10,902 men and 16,814 women ages 45 to 73 years who participated in the Malmö Diet and Cancer Study in Sweden. Baseline examinations took place between 1991 and 1996, and 982 deaths were documented during an average follow‐up of 5.7 years. All‐cause mortality was related to the following variables measured at baseline: body mass index (BMI), percentage of body fat, lean body mass (LBM), and waist‐to‐hip ratio (WHR), with adjustment for age and selected covariates. Body composition data were derived from bioelectrical impedance analysis. Results: The association between percentage of body fat and mortality was modified by age, particularly in women. For instance, fatness was associated with excess mortality in the younger women but with reduced mortality in the older women. Weaker associations were seen for BMI than for percentage of body fat in both sexes. Placement in the top quintiles of waist‐to‐hip ratio, independent of overall body fat, was a stronger predictor of mortality in women than in men. The observed associations could not be explained by bias from early death or antecedent disease. Discussion: The findings reveal sex and age differences for the effects of adiposity and WHR on mortality and indicate the importance of considering direct measures of adiposity, as opposed to BMI, when describing obesity‐related mortality risks.  相似文献   

3.
Objective: Our goal was to examine five different measures of adiposity as predictors of all‐cause mortality. Research Methods and Procedures: Subjects were 16,969 men and 24,344 women enrolled between 1990 and 1994 in the Melbourne Collaborative Cohort Study (27 to 75 years of age). There were 2822 deaths over a median follow‐up period of 11 years. BMI, waist circumference, and waist‐to‐hip ratio were obtained from direct anthropometric measurements. Fat mass and percentage fat were estimated by bioelectric impedance analysis. Results: Comparing the top quintile with the second quintile, for men there was an increased risk of between 20% and 30% for all‐cause mortality associated with each of the anthropometric measures. For women, there was an increased risk of 30% (95% confidence interval for hazard ratio, 1.1–1.6) observed for waist circumference and 50% (1.2–1.8) for waist‐to‐hip ratio, but little or no increased risk for BMI, fat mass, and percentage fat. Waist‐to‐hip ratio was positively and monotonically associated with all‐cause mortality for both men and women. There was a linear association between waist circumference and all‐cause mortality for men, whereas a U‐shaped association was observed for women. Discussion: Measures of central adiposity were better predictors of mortality in women in the Melbourne Collaborative Cohort Study compared with measures of overall adiposity. We recommend measuring waist and hip circumferences in population studies investigating the risk of all‐cause mortality associated with obesity. The use of additional measures such as bioelectric impedance is not justified for this outcome.  相似文献   

4.
Objective: The purpose of this study is to evaluate the validity of BMI based on self‐reported data by comparison with technician‐measured BMI and biomarkers of adiposity. Research Methods and Procedures: We analyzed data from 10,639 National Health and Nutrition Education Study III participants ≥20 years of age to compare BMI calculated from self‐reported weight and height with BMI from technician‐measured values and body fatness estimated from bioelectrical impedance analysis in relation to systolic blood pressure, fasting blood levels of glucose, high‐density lipoprotein‐cholesterol, triglycerides, C‐reactive protein, and leptin. Results: BMI based on self‐reported data (25.07 kg/m2) was lower than BMI based on technician measurements (25.52 kg/m2) because of underreporting weight (?0.56 kg; 95% confidence interval, ?0.71, ?0.41) and overreporting height (0.76 cm; 95% confidence interval, 0.64, 0.88). However, the correlations between self‐reported and measured BMI values were very high (0.95 for whites, 0.93 for blacks, and 0.90 for Mexican Americans). In terms of biomarkers, self‐reported and measured BMI values were equally correlated with fasting blood glucose (r = 0.43), high‐density lipoprotein‐cholesterol (r = ?0.53), and systolic blood pressure (r = 0.54). Similar correlations were observed for both measures of BMI with plasma concentrations of triglycerides and leptin. These correlations did not differ appreciably by age, sex, ethnicity, or obesity status. Correlations for percentage body fat estimated through bioelectrical impedance analysis with these biomarkers were similar to those for BMI. Discussion: The accuracy of self‐reported BMI is sufficient for epidemiological studies using disease biomarkers, although inappropriate for precise measures of obesity prevalence.  相似文献   

5.
The aim of the study was to estimate the association between relative weight in childhood and adolescence and its relationship with adult health outcome. Longitudinal data of the body mass index (BMI) from the Wroc?aw Growth Study (WGS) covering ages 8 to 18 and then a follow-up at 50 were used. At the age of 50, 124 males and 139 females in the longitudinal study underwent medical examination. Systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TCH), high density lipoprotein cholesterol level (HDL), low density lipoprotein cholesterol level (LDL), triglyceride level (TGL) and fasting glucose level (GLUC) were assessed by using standard techniques. The values of BMI were standardised with the LMS method. Multiple linear regression was used to assess the relationship between health parameters and BMI at ages 8-18, adjusted for BMI at the age of 50, separately for different age categories and parameters, except for blood pressure where the usage of anti-hypertension medication was additionally used as a control variable. In males total cholesterol concentration showed a significant negative correlation with standardised BMI at ages 9-12 and 16 and 17. In females, only blood pressure showed a significant negative relationship with standardised BMI in all age categories reaching the highest values at age 15. The BMI in childhood and adolescence have only a weak effect on health outcome at age 50.  相似文献   

6.
7.
Parasites can cause severe host morbidity and threaten survival. As parasites are generally aggregated within certain host demographics, they are likely to affect a small proportion of the entire population, with specific hosts being at particular risk. However, little is known as to whether increased host mortality from parasitic causes is experienced by specific host demographics. Outside of theoretical studies, there is a paucity of literature concerning dynamics of parasite‐associated host mortality. Empirical evidence mainly focuses on short‐lived hosts or model systems, with data lacking from long‐lived wild or semi‐wild vertebrate populations. We investigated parasite‐associated mortality utilizing a multigenerational database of mortality, health, and reproductive data for over 4,000 semi‐captive timber elephants (Elephas maximus), with known causes of death for mortality events. We determined variation in mortality according to a number of host traits that are commonly associated with variation in parasitism within mammals: age, sex, and reproductive investment in females. We found that potentially parasite‐associated mortality varied significantly across elephant ages, with individuals at extremes of lifespan (young and old) at highest risk. Mortality probability was significantly higher for males across all ages. Female reproducers experienced a lower probability of potentially parasite‐associated mortality than females who did not reproduce at any investigated time frame. Our results demonstrate increased potentially parasite‐associated mortality within particular demographic groups. These groups (males, juveniles, elderly adults) have been identified in other studies as susceptible to parasitism, stressing the need for further work investigating links between infection and mortality. Furthermore, we show variation between reproductive and non‐reproductive females, with mothers being less at risk of potentially parasite mortality than nonreproducers.  相似文献   

8.
Objective: Measurement of waist circumference alone as a proxy of abdominal fat mass has been suggested as a simple clinical alternative to BMI for detecting adults with possible health risks due to obesity. Research Methods and Procedures: From 1993 to 1997, 27, 178 men and 29, 875 women, born in Denmark, 50 to 64 years of age, were recruited in the Danish prospective study Diet, Cancer and Health. By the end of the year 2000, 1465 deaths had occurred. We evaluated the relationship between waist circumference and BMI (simultaneously included in the model) and all‐cause mortality. We used Cox regression models to estimate the mortality‐rate ratios and to consider possible confounding from smoking. Results: Waist circumference among both men and women showed a strong dose‐response type of relationship with mortality when adjusted for BMI, whereas the low range of BMI was inversely associated with mortality when adjusted for waist circumference. A 10% larger waist circumference corresponded to a 1.48 (95% confidence interval: 1.36 to 1.61) times higher mortality over the whole range of waist circumference. The associations were independent of age and time since baseline examination. Restriction to never smokers showed a similar pattern, but a weakening of the associations. Discussion: Despite the high correlation between waist circumference and BMI, the combination may be very relevant in clinical practice because waist circumference for given BMI was a strong predictor of all‐cause mortality. The inverse association between BMI and mortality for given waist circumference was diminished in never smokers, particularly for high values of BMI.  相似文献   

9.
Objective : Percent fat is often considered the reference for establishing the magnitude of adipose tissue accumulation and the risk of excess adiposity. However, the increasing recognition of a strong link between central adiposity and metabolic disturbances led us to test whether waist circumference (WC) is more highly correlated with metabolic syndrome components than percent fat and other related anthropometric measures such as BMI. Research Methods and Procedures : BMI, WC, and percent fat, measured by DXA, were evaluated in 1010 healthy white and African‐American men and women [age, 48.3 ± 17.2 (standard deviation) years; BMI, 27.0 ± 5.3 kg/m2]. The associations of BMI, WC, and percent fat with age and laboratory‐adjusted health risk indicators (i.e., serum glucose, insulin, triglycerides, high‐density lipoprotein cholesterol, blood pressure) in each sex and ethnicity group were examined. Results : For 18 of 24 comparisons, the age‐ and laboratory‐adjusted correlations were lowest for percent fat and in 16 of 24 comparisons were highest for WC. Fifteen of the between‐method differences reached statistical significance. With health risk indicator as the dependent variable and anthropometric measures as the independent variable, the contribution of percent fat to the WC regression model was not statistically significant; in contrast, adding WC to the percent fat regression model did make a significant independent contribution for most health risk indicators. Discussion : WC had the strongest associations with health risk indicators, followed by BMI. Although percent fat is a useful measure of overall adiposity, health risks are best represented by the simply measured WC.  相似文献   

10.
Individuals with psychosis are more likely than the general community to develop obesity and to die prematurely from heart disease. Interventions to improve cardiovascular outcomes are best targeted at the earliest indicators of risk, at the age they first emerge. We investigated which cardiometabolic risk indicators distinguished those with psychosis from the general population, by age by gender, and whether obesity explained the pattern of observed differences. Data was analyzed from an epidemiologically representative sample of 1,642 Australians with psychosis aged 18–64 years and a national comparator sample of 8,866 controls aged 25–64 years from the general population. Cubic b-splines were used to compare cross sectional age trends by gender for mean waist circumference, body mass index [BMI], blood pressure, fasting blood glucose, triglycerides, LDL, HDL, and total cholesterol in our psychosis and control samples. At age 25 individuals with psychosis had a significantly higher mean BMI, waist circumference, triglycerides, glucose [women only], and diastolic blood pressure and significantly lower HDL-cholesterol than controls. With the exception of triglycerides at age 60+ in men, and glucose in women at various ages, these differences were present at every age. Differences in BMI and waist circumference between samples, although dramatic, could not explain all differences in diastolic blood pressure, HDL-cholesterol or triglycerides but did explain differences in glucose. Psychosis has the hallmarks of insulin resistance by at least age 25. The entire syndrome, not just weight, should be a focus of intervention to reduce mortality from cardiovascular disease.  相似文献   

11.
Background: Optimization of the indications for nocturnal polysomnography in the diagnosis of obstructive sleep apnea syndrome (OSAS) could lead to significant reductions in health expenditure. To this end, we assessed the usefulness of truncal obesity measurements in the diagnosis of OSAS. Methods and Procedures: One hundred ninety‐two patients (152 men and 40 women) referred to our clinic with suspected OSAS underwent a complete polysomnography study and their BMI and truncal obesity measurements were obtained. Results: Comparison of patients defined as snorers with OSAS patients, by means of the Student's t ‐test revealed significant differences in the truncal obesity parameters such as waist‐to‐hip ratio (0.94 vs. 0.98) and waist circumference (100.7 cm vs. 106.3 cm). We found no significant differences between BMI values in the two groups. Indices of truncal obesity were analyzed as predictive factors for OSAS using a multivariate logistic regression model that included variable sex, and in which waist‐to‐hip ratio, BMI, neck circumference, and age were analyzed as binary variables. According to this model, our patients' risk of suffering from OSAS was 2.6 times greater if the waist‐to‐hip ratio was >1 in men and >0.85 in women. The risk of OSAS was also increased if the patients were men or over 52 years of age. Discussion: Obtaining simple measurements such as those for truncal obesity may help prioritize the use of polysomnography in patients with a greater risk of OSAS. Our results suggest that BMI is not a good predictor of OSAS in a group of patients with a high BMI.  相似文献   

12.
Many biomarkers have been shown to be associated not only with chronological age but also with functional measures of biological age. In human populations, it is difficult to show whether variation in biological age is truly predictive of life expectancy, as such research would require longitudinal studies over many years, or even decades. We followed adult cohorts of 20 Drosophila Genetic Reference Panel (DGRP) strains chosen to represent the breadth of lifespan variation, obtain estimates of lifespan, baseline mortality, and rate of aging, and associate these parameters with age‐specific functional traits including fecundity and climbing activity and with age‐specific targeted metabolomic profiles. We show that activity levels and metabolome‐wide profiles are strongly associated with age, that numerous individual metabolites show a strong association with lifespan, and that the metabolome provides a biological clock that predicts not only sample age but also future mortality rates and lifespan. This study with 20 genotypes and 87 metabolites, while relatively small in scope, establishes strong proof of principle for the fly as a powerful experimental model to test hypotheses about biomarkers and aging and provides further evidence for the potential value of metabolomic profiles as biomarkers of aging.  相似文献   

13.
Dietary restriction (DR) extends lifespan in multiple species from various taxa. This effect can arise via two distinct but not mutually exclusive ways: a change in aging rate and/or vulnerability to the aging process (i.e. initial mortality rate). When DR affects vulnerability, this lowers mortality instantly, whereas a change in aging rate will gradually lower mortality risk over time. Unraveling how DR extends lifespan is of interest because it may guide toward understanding the mechanism(s) mediating lifespan extension and also has practical implications for the application of DR. We reanalyzed published survival data from 82 pairs of survival curves from DR experiments in rats and mice by fitting Gompertz and also Gompertz–Makeham models. The addition of the Makeham parameter has been reported to improve the estimation of Gompertz parameters. Both models separate initial mortality rate (vulnerability) from an age‐dependent increase in mortality (aging rate). We subjected the obtained Gompertz parameters to a meta‐analysis. We find that DR reduced aging rate without affecting vulnerability. The latter contrasts with the conclusion of a recent analysis of a largely overlapping data set, and we show how the earlier finding is due to a statistical artifact. Our analysis indicates that the biology underlying the life‐extending effect of DR in rodents likely involves attenuated accumulation of damage, which contrasts with the acute effect of DR on mortality reported for Drosophila. Moreover, our findings show that the often‐reported correlation between aging rate and vulnerability does not constrain changing aging rate without affecting vulnerability simultaneously.  相似文献   

14.

Objective:

The accuracy of anthropometric surrogate markers such as the body adiposity index (BAI) and other common indexes like the body mass index (BMI), waist‐to‐hip ratio (WHR) and waist‐to‐height ratio (WHtR) to predict metabolic sequelae is essential for its use in clinical practice.

Design and Methods:

Thus, we evaluated the strength of BAI and other indexes to relate with anthropometric parameters, adipocytokines, blood lipids, parameters of glucose‐homeostasis and blood pressure in 1,770 patients from the Salzburg Atherosclerosis Prevention Program in Subjects at High Individual Risk (SAPHIR) study in a crosssectional design. Measurements were BAI, BMI, WHR, WHtR, abdominal subcutaneous and visceral adipose tissue (aSAT and VAT), total body adipose tissue mass, body weight, waist‐ and hip circumference (WC and HC), leptin, adiponectin, high‐density lipoprotein‐cholesterol (HDL‐C), low‐density lipoprotein‐cholesterol (LDL‐C), triglycerides (TG), fasting plasma glucose, fasting plasma insulin, the homeostasis model assessment of insulin resistance (HOMAIR), systolic and diastolic blood pressure.

Results and Conclusions:

BAI was significantly associated with leptin and HC. We conclude that BAI was the best calculator for leptin. BAI was inferior to BMI to predict anthropometric parameters other than HC, adiponectin, blood lipids, parameters of glucose homeostasis, and blood pressure in this cross‐sectional study.  相似文献   

15.
Objective: To examine the effect of reverse causality and confounding on the association of BMI with all‐cause and cause‐specific mortality. Research Methods and Procedures: Data from two large prospective studies were used. One (a community‐based cohort) included 8327 women and 7017 men who resided in two Scottish towns at the time of the baseline assessment in 1972–1976; the other (an occupational cohort) included 4016 men working in the central belt of Scotland at the time of the baseline assessment in 1970–1973. Participants in both cohorts were ages 45 to 64 years at baseline; the follow‐up period was 28 to 34 years. Results: In age‐adjusted analyses that did not take account of reverse causality or smoking, there was no association between being overweight (BMI 25 to <30 kg/m2) and mortality, and weak to modest associations between obesity (BMI ≥30 kg/m2) and mortality. There was a strong association between smoking and lower BMI in women and men in both cohorts (all p < 0.0001). Among never‐smokers and with the first 5 years of deaths removed, overweight was associated with an increase in all‐cause mortality (relative risk ranging from 1.12 to 1.38), and obesity was associated with a doubling of risk in men in both cohorts (relative risk, 2.10 and 1.96, respectively) and a 60% increase in women (relative risk, 1.56). In both never‐smokers and current smokers, being overweight or obese was associated with important increases in the risk of cardiovascular disease. Discussion: These findings demonstrate that with appropriate control for smoking and reverse causality, both overweight and obesity are associated with important increases in all‐cause and cause‐specific mortality, and in particular with cardiovascular disease mortality.  相似文献   

16.
Cross-sectional studies have repeatedly suggested peripheral blood monocyte telomere length as a biomarker of aging. To test this suggestion in a large population-based follow-up study of the oldest old, we measured telomere length at baseline in 598 participants of the Leiden 85-plus Study (mean age at baseline 89.8 years). We also obtained second telomere measurements from 81 participants after an average time span of between 3.9 and 12.9 years. Telomere length at baseline was not predictive for mortality (P > 0.40 for all-cause, cardiovascular causes, cancer or infectious diseases, Cox regression for gender-adjusted tertiles of telomere length) or for the incidence of dementia (P = 0.78). Longitudinally, telomere length was highly unstable in a large fraction of participants. We conclude that blood monocyte telomere length is not a predictive indicator for age-related morbidity and mortality at ages over 85 years, possibly because of a high degree of telomere length instability in this group.  相似文献   

17.
Objective: To describe and evaluate relationships between body mass index (BMI) and blood pressure, cholesterol, high‐density lipoprotein‐cholesterol (HDL‐C), and hypertension and dyslipidemia. Research Methods and Procedures: A national survey of adults in the United States that included measurement of height, weight, blood pressure, and lipids (National Health and Nutrition Examination Survey III 1988–1994). Crude age‐adjusted, age‐specific means and proportions, and multivariate odds ratios that quantify the association between hypertension or dyslipidemia and BMI, controlling for race/ethnicity, education, and smoking habits are presented. Results: More than one‐half of the adult population is overweight (BMI of 25 to 29.9) or obese (BMI of ≥30). The prevalence of high blood pressure and mean levels of systolic and diastolic blood pressure increased as BMI increased at ages younger than 60 years. The prevalence of high blood cholesterol and mean levels of cholesterol were higher at BMI levels over 25 rather than below 25 but did not increase consistently with increasing BMI above 25. Rates of low HDL‐C increased and mean levels of HDL‐C decreased as levels of BMI increased. The associations of BMI with high blood pressure and abnormal lipids were statistically significant after controlling for age, race or ethnicity, education, and smoking; odds ratios were highest at ages 20 to 39 but most trends were apparent at older ages. Within BMI categories, hypertension was more prevalent and HDL‐C levels were higher in black than white or Mexican American men and women. Discussion: These data quantify the strong associations of BMI with hypertension and abnormal lipids. They are consistent with the national emphasis on prevention and control of overweight and obesity and indicate that blood pressure and cholesterol measurement and control are especially important for overweight and obese people.  相似文献   

18.
Objective: The shape of the association between BMI (kg/m2) and mortality has important methodological implications as it partially determines the optimal form for operationalizing BMI for use in analyses. We examined various BMI operationalizations in relation to mortality from all causes and specific causes. Methods and Procedures: A clinical examination with measurements of height and weight was conducted at baseline (1967–1970) for 18,860 working men aged 40–69, in the total cohort and 7,865 men in the healthy subcohort, that is, those who had no unexplained weight loss, no cardiovascular (CVD) or respiratory disease, were nonsmokers and did not die during the first 5 years of follow‐up (the original Whitehall study). A mean follow‐up of 35 years for mortality gave rise to 13,498 deaths of which 4,766 were in the healthy subcohort. Results: There was a dose‐response relation between BMI and CVD and coronary heart disease (CHD) mortality in the total cohort and healthy subcohort, with an increasingly steep slope at the high end of the BMI distribution. For noncardiovascular, cancer, and respiratory mortality, an excess risk was also associated with a BMI <18.5; in the healthy subcohort, this was true only for respiratory deaths. The association between BMI and all‐cause mortality was J‐shaped in the total cohort and healthy subgroup and even after excluding underweight participants. Discussion: For associations with all‐cause and cause‐specific mortality, a linear and quadratic term in combination provided a more parsimonious BMI operationalization than the WHO definition, obese‐nonobese dichotomy or BMI treated as a continuous linear variable.  相似文献   

19.
Muscle strength is a major component of successful performance in almost every activity of daily living and it is critical to health and well-being. Anthropometric, blood pressure and strength measurements were taken from Oraon agricultural labourers of Jalpaiguri district of West Bengal. The data were analyzed to find out the differences between high and low back strength groups of both sexes in different traits of the parameters mentioned above. Secondly, identifying the peak age of muscle strength in both sex and the declining ages. Thirdly, the influencing factors which, affect the back strength. The results show that high back strength groups have higher mean values of most of the anthropometric traits compared to low back strength groups and the differences are significant in case of males, but females show significant differences in few traits. Blood pressures are relatively low in high back strength groups compared to low back strength groups in both sexes. The peak age for higher back strength seems to be within the age of 24 years for males and 20 years for females. The predictive variables for males were found to be grip strength and subscapular skinfold thickness, but females show grip strength, BMI, biceps girth, bicondylar diameter of humerus. The differences in influencing factors between males and females have been sorted out from sociocultural practice of the population.  相似文献   

20.
Many captive chimpanzees (Pan troglodytes) are subjectively considered to be overweight or obese. However, discussions of obesity in chimpanzees are rare in the literature, despite the acknowledged problem. No study to date has systematically examined obesity in captive chimpanzees. This project develops guidelines for defining obesity in captive chimpanzees through the examination of morphometric and physiologic characteristics in 37 adult female and 22 adult male chimpanzees. During each animal's biannual physical exam, morphometric data was collected including seven skinfolds (mm), body mass index (BMI), waist‐to‐hip ratio (WHR), and total body weight (kg). The morphometric characteristics were correlated with triglycerides and serum glucose concentration, to test the utility of morphometrics in predicting relative obesity in captive chimpanzees. Abdominal skinfold (triglyceride: F=3.83, P=0.05; glucose: F=3.83, P=0.05) and BMI (triglyceride: F=10.42, p=0.003; glucose: F=6.20, P=0.02) were predictive of increased triglycerides and serum glucose in females; however no morphometric characteristics were predictive of relative obesity in males. Results suggest that no males in this population are overweight or obese. For females, there were additional significant differences in morphometric (skinfolds, BMI, WHR, total body weight) and physiologic measurements (systolic and diastolic blood pressure, red blood cells) between individuals classified overweight and those classified non‐overweight. Skinfold measurements, particularly abdominal, seem to be an accurate measure of obesity and thus potential cardiovascular risk in female chimpanzees, but not males. By establishing a baseline for estimated body fat composition in female captive chimpanzees, institutions can track individuals empirically determined to be obese, as well as obesity‐related health problems. Zoo Biol 0:1–12, 2007. © 2007 Wiley‐Liss, Inc.  相似文献   

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