Sagittal Abdominal Diameter does not Predict Metabolic Traits Better than Waist Circumference-Related Measures of Abdominal Obesity in Obese Subjects

Abstract Background Recently, we showed that in subjects with a body mass index (BMI) >35 kg/m2 waist circumference (WC) is associated with metabolic traits but associations were weaker in men than in women. Aims To confirm our previous observation that anthropometric measures of abdominal obesity are closer linked to metabolic traits in obese women than obese men. To test whether sagittal abdominal diameter (SAD) provides a better prediction of metabolic traits in obese subjects than WC related measures. Methods SAD and WC along with metabolic traits were assessed in 204 women and 69 men (BMI 30.1–64.0 kg/m2). Results In women, abdominal obesity measures were associated with glycated hemoglobin levels (HbA1c), fasting serum glucose, insulin, triglycerides (TG), total cholesterol (Chol), high-density lipoprotein (HDL), and uric acid levels as well as Chol/HDL ratio and homeostatic model assessment of insulin resistance (HOMA-IR) independently of age and BMI. SAD predicted serum insulin and Chol better than WC, whereas WC was superior to SAD in predicting HbA1c, glucose, HOMA-IR, TG, HDL, Chol/HDL, and uric acid. Of note, the combination of SAD and WC provided a better prediction of insulin, HOMA-IR, TG, and uric acid than each of these anthropometric alone. In men, only fasting glucose, Chol, and uric acid levels were associated with abdominal obesity markers. Conclusion Data show various associations between anthropometric measures of abdominal obesity and metabolic traits in obese women but overall much less in obese men. Most metabolic traits are better predicted by WC than by SAD.

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Waist Circumference and Related Anthropometric Indices Are Associated with Metabolic Traits in Severely Obese Subjects

Obesity Surgery ◽

10.1007/s11695-013-1141-6 ◽

2013 ◽

Vol 24 (5) ◽

pp. 777-782 ◽

Cited By ~ 6

Author(s):

Runa Zazai ◽

Britta Wilms ◽

Barbara Ernst ◽

Martin Thurnheer ◽

Bernd Schultes

Keyword(s):

Waist Circumference ◽

Anthropometric Indices ◽

Metabolic Traits ◽

Severely Obese ◽

Obese Subjects

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Uric acid as a future biomarker in diagnosing metabolic syndrome patients.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.11.3191 ◽

2019 ◽

Vol 26 (11) ◽

pp. 1911-1915

Author(s):

Shameela Majeed ◽

Brig. Rizwan Hashim

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Uric Acid ◽

Waist Circumference ◽

Serum Uric Acid ◽

Serum Triglyceride ◽

Military Hospital ◽

P Value ◽

Model Assessment ◽

R Value

Objectives: To determine the possible correlation between raised serum uric acid and various components of metabolic syndrome (Waist circumference, serum triglyceride, plasma HDL-C). Study Design: Descriptive case control. Setting: Army Medical College laboratory, Military Hospital, Rawalpindi. Period: One year (November 2014 to October 2015). Material and Methods: Total of 100 subjects were enrolled in this study. WHO criteria were applied for identifying the patients of metabolic syndrome. Fasting plasma glucose, lipid profile and serum uric acid levels were measured by using colorimetric enzymatic method. The formula of Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) was applied to calculate Insulin resistance. Collected data was analyzed by using SPSS- Window version-17 for statistical analysis. Results: Serum uric acid levels were turned out to be high in metabolic syndrome patients (cases= 6.1±1.3mg/dL) when compared with controls (having no symptoms of MetS=3.6±1.2; p<0.001). Uric acid showed a statistically significant positive association with waist circumference (WC=r-value:0.250; p-value:0.000) and serum triglyceride (TG=r-value:0.341; p-value:0.000). Negative correlation had been found between plasma high-density lipoprotein-cholesterol (HDL-C=r-value: -0.173; p-value:<0.01) with uric acid levels. Conclusion: Serum uric acid levels show a significant association with components of metabolic syndrome making it a powerful biomarker of metabolic syndrome and its various cardiometabolic complications.

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Longitudinal Associations between Obesity, Inflammation, and the Incidence of Type 2 Diabetes Mellitus among US Black and White Adults in the CARDIA Study

Journal of Diabetes Research ◽

10.1155/2020/2767393 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Sharon H. Jackson ◽

Anna Bellatorre ◽

Timothy McNeel ◽

Anna María Nápoles ◽

Kelvin Choi

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Uric Acid ◽

Waist Circumference ◽

Self Report ◽

Model Assessment ◽

High Waist Circumference ◽

Diabetes Status

Aim. Assess prospective relationships between obesity and inflammation on the incidence of type 2 diabetes mellitus (T2DM). Methods. A cohort of nondiabetic respondents from the Coronary Artery Risk Development in Young Adults (CARDIA) study was followed from 2005-2006 (wave 7) to 2010-2011 (wave 8). Diabetes status was determined in wave 8 based on self-report, blood glucose level, and anti-hyperglycemic medication use in conjunction with a homeostatic model assessment-based classification for distinguishing diabetes subtype. We performed a series of multivariable logistic regression analyses to assess the relative influence of obesity (waist circumference) and individual inflammatory biomarkers (i.e., C-reactive protein, fibrinogen, and sex-specific serum uric acid and gamma-glutamyltransferase) on the odds of developing incident T2DM between waves 7 and 8. Results. Among 2784 nondiabetic CARDIA respondents, 146 (5.2%) new cases of T2DM were identified between waves. Having a high waist circumference (AOR=6.15; 95%CI=4.14,9.14) and being Black (vs. White) (AOR=1.60; 95%CI=1.05,2.44) were associated with T2DM. Adjusting for inflammation biomarkers attenuated the effects of waist circumference and race with T2DM. Clinically elevated CRP (AOR=1.83; 95%CI=1.18,2.82) and uric acid (AOR=2.57; 95%CI=1.70,3.89) predicted T2DM among all respondents. However, stratification by race showed greater attenuation of the effects of waist circumference on T2DM in Whites than in Blacks when inflammation biomarkers were accounted for in the model. Conclusion. Targeted control of systemic inflammation may reduce the risk of developing T2DM, especially among Blacks, and could help address Black-White disparities in diabetes care and outcomes.

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The Impact of Abdominal Obesity Status on Cardiovascular Response to the Mediterranean Diet

Journal of Obesity ◽

10.1155/2012/969124 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 8

Author(s):

Alexandra Bédard ◽

Sylvie Dodin ◽

Louise Corneau ◽

Simone Lemieux

Keyword(s):

Waist Circumference ◽

Total Cholesterol ◽

Mediterranean Diet ◽

Abdominal Obesity ◽

Cardiovascular Response ◽

Time Effect ◽

Time Interaction ◽

Obesity Status ◽

Obese Subjects ◽

The Impact

We investigated the impact of abdominal obesity status on the cardiovascular response to a fully controlled 4-week isoenergetic Mediterranean diet (MedDiet). Thirty-eight abdominally obese individuals (waist circumference >102 cm in men and >88 cm in women) and thirty-one nonabdominally obese individuals were recruited and studied before and after the MedDiet. All analyses were adjusted for the slight decrease in body weight, which occurred during the MedDiet (mean:0.9±1.2 kg). A group by time interaction was noted for waist circumference (P=0.02), abdominally obese subjects showing a significant decrease and nonabdominally obese subjects a nonsignificant increase (resp., −1.1 and +0.3%). The MedDiet resulted in decreases in total cholesterol, LDL-C, HDL-C, apolipoprotein B, A-1, and A-2, total cholesterol/HDL-C ratio, LDL-C/HDL-C ratio, and systolic and diastolic blood pressure (time effect:P<0.05). For all variables related to glucose/insulin homeostasis, no change was observed except for a decrease in 2 h glucose concentrations (time effect:P=0.03). No group by time interaction was observed in any of the metabolic variables studied. Results from our study suggest that the adoption of the MedDiet leads to beneficial metabolic effects, irrespective of the abdominal obesity status.

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Phosphodiesterase 4 Inhibition as a Potential New Therapeutic Target in Obese Women With Polycystic Ovary Syndrome

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2014-1430 ◽

2014 ◽

Vol 99 (8) ◽

pp. E1476-E1481 ◽

Cited By ~ 24

Author(s):

Mojca Jensterle ◽

Tomaz Kocjan ◽

Andrej Janez

Keyword(s):

Body Weight ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Combined Treatment ◽

Pde4 Inhibitor ◽

Model Assessment ◽

Obese Women ◽

Ovary Syndrome ◽

Anthropometric Measures ◽

Positive Effects

Context: Phosphodiesterase (PDE) enzymes, including members of PDE4, have been investigated in the regulation of endocrine and reproductive functions of ovaries. In addition, selective inhibition of PDE4 enzyme has recently been implicated in the regulation of metabolism with positive effects on glucose homeostasis and weight reduction. Objective: The aim of this study was to evaluate whether the PDE4 inhibitor roflumilast affects body weight and hormonal and metabolic status in obese women with polycystic ovary syndrome (PCOS). Design/Participants/Main Outcome Measures: A 12-week prospective randomized open-label study was conducted with 36 obese women with PCOS diagnosed by the National Eunice Kennedy Shriver Institute of Child Health and Human Development criteria that had been pretreated with metformin (MET). They were randomized to MET 1000 mg twice a day or combined treatment (COM) with MET 1000 mg twice a day and roflumilast 500 μg every day. The primary outcome was change in anthropometric measures of obesity. Results: Thirty-one patients (aged 33.8 ± 7.4 y, twice a day 36.4 ± 5.1 kg/m2, mean ± SD) completed the study: 16 on MET and 15 on COM. Subjects treated with COM lost on average 4.2 ± 2.8 kg compared with a 0.9 ± 2.5 kg weight gain in the MET group (P = .025). Body mass index decreased for 1.6 ± 1.1 kg/m2 in COM arm compared with increase for 0.9 ± 2.4 kg/m2 in the MET arm (P = .046). Visceral adipose tissue area as assessed by dual-energy x-ray absorptiometry decreased from 136.7 ± 37.8 to 121.2 ± 36.2 cm2 in the COM arm compared with an increase from 155.3 ± 61.9 to 166.7 ± 67.2 cm2 in the MET arm (P = .02). From baseline to study end, both treatment interventions resulted in a significant reduction of androstenedione (P = .013), free T (P = .002), and homeostasis model assessment for insulin resistance score (P = .027) and a significant increase in SHBG (P = .024), although the between-treatment differences of the changes have not been statistically significant yet. Conclusion: Roflumilast added to metformin reduced body weight in obese women with PCOS, primarily due to a loss of fat mass.

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Assessment of Obesity using Anthropometric Markers among University Students

Current Research in Nutrition and Food Science Journal ◽

10.12944/crnfsj.9.1.21 ◽

2021 ◽

Vol 9 (1) ◽

pp. 211-221

Author(s):

Astha Astha ◽

Bindu Krishnan ◽

Anup Kharde

Keyword(s):

Young Adults ◽

Waist Circumference ◽

Abdominal Obesity ◽

Central Obesity ◽

Normal Weight ◽

Asia Pacific ◽

General Obesity ◽

Height Ratio ◽

Anthropometric Measures ◽

High Positive Correlation

Over the past few decades there has been an increase in the central or abdominal obesity. Endothelial dysfunction, insulin resistance with metabolic syndrome and a higher cardiometabolic risk are directly linked to abdominal obesity. A better understanding of the epidemiology of obesity would provide insights to its mitigation. This cross sectional study was designed to identify Central obesity, General obesity and Normal Weight central obesity among young adults using the following surrogate markers Waist circumference (WC), Waist hip ratio (WHR), Waist height ratio (WtHR) and BMI. After due informed written consent, 300 young adults with equal representation of both sexes (150 each) studying MBBS, Dentistry and Physiotherapy stream in a private university were selected. Various anthropometric measures like weight, hip circumference and waist circumference and height were measured according to WHO STEPS instrument. BMI based on Asia- Pacific cut -off values was used to define general obesity. Central obesity was defined by a Waist Circumference of  80 cm in females and  90 cm in male’s .For waist to height ratio a value of  0.5 in both genders was used. For waist to hip ratio the cut off value used was 0.85 in females and 0.90 in males. An individual with normal weight according to BMI but having central obesity fits into Normal Weight Central obesity category. Average age of the participants was 20.6 1.31 years. General Obesity was more among males with 46% prevalence as compared to 25.33%among females. In contrast, the prevalence of central obesity was more among females. The prevalence of Normal weight central obesity was more among females, varying from 4% to 17% using different types of anthropometric measures for central obesity. A high positive correlation was observed between BMI with WC, WtHR and WHR. (p=0.0001) Current practice of taking only BMI into consideration for defining obesity in our country needs serious re-evaluation considering the increasing prevalence of abdominal obesity and its long term impact.

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Abdominal Obesity Phenotype Predicts COVID-19 Chest X-Ray Severity Score better than General Obesity

10.21203/rs.3.rs-167177/v1 ◽

2021 ◽

Author(s):

Alexis Elias Malavazos ◽

Francesco Secchi ◽

Sara Basilico ◽

Gloria Capitanio ◽

Sara Boveri ◽

...

Keyword(s):

Waist Circumference ◽

Abdominal Obesity ◽

Risk Ratio ◽

Severity Score ◽

Multivariable Analysis ◽

Hospitalized Patients ◽

General Obesity ◽

X Ray ◽

Severity Scores ◽

Better Than

Abstract PurposeChest x-ray (CXR) severity score and general obesity are predictive risk factors for COVID-19 hospital admission. However, the relationship between abdominal obesity and CXR severity score has not yet been fully explored.MethodsThis retrospective cohort study analyzed the association of different adiposity indexes, including waist circumference and body mass index (BMI), with CXR severity score in 215 hospitalized patients with COVID-19.ResultsPatients with abdominal obesity had significantly higher CXR severity scores and higher rates of these scores than those without abdominal obesity (P<0.001; P=0.001, respectively). While, there were no significant differences between BMI classes (P=0.104; P=0.271, respectively). Waist circumference and waist-to-height ratio (WHtR) correlated more closely with CXR severity score than BMI (r=0.43, P<0.001; r=0.41, P<0.001; r=0.17, P=0.012, respectively). The area under the curves (AUCs) for waist circumference and WHtR were significantly higher than those for BMI for distinguishing a high CXR severity score (≥8) (0.68 [0.60-0.75] and 0.67 [0.60-0.74] vs 0.58 [0.51-0.66], P=0.001). Multivariable analysis indicated abdominal obesity (risk ratio: 1.75, 95% CI: 1.25-2.45, P<0.001), bronchial asthma (risk ratio: 1.73, 95% CI: 1.07-2.81, P=0.026) and oxygen saturation at admission (risk ratio: 0.96, 95% CI: 0.94-0.97, P<0.001) as the only independent predictors of a high CXR severity score. ConclusionAbdominal obesity might predict a high CXR severity score better than general obesity in hospitalized patients with COVID-19. Therefore, when performing clinical hospital practices, waist circumference should be assessed, and patients with abdominal obesity should be monitored closely when hospitalized.

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Abstract 10397: Higher Waist Circumference is the Start of Cardiovascular Structural and Functional Changes in Childhood Obesity

Circulation ◽

10.1161/circ.132.suppl_3.10397 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Kenji Harada ◽

Yukiko Harada ◽

Manatomo Toyono

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Uric Acid ◽

Waist Circumference ◽

Fasting Glucose ◽

Volume Ratio ◽

Left Ventricular ◽

Model Assessment ◽

Functional Changes ◽

Late Diastole

Background: Higher waist circumference (WC) is associated with cardiovascular disease, however, little is known about the association between WC and cardiovascular functional change in children. The purpose of this study is to examine the relationships between numbers of cardiovascular risk factors and left ventricular (LV) geometry and function in children. Methods: Echocardiography was performed in 311 children aged 7 to 13 years. Left atrial (LA) diameter, LV end-diastolic volume, ejection fraction, mass, mass-to-volume ratio, and carotid artery intima media-thickness (IMT) were measured. Transmitral peak flow velocities during early and late diastole and mitral annular myocardial velocities during early (Em) and late diastole (Am) were measured. LA systolic force and aortic stiffness were calculated. Lipids, uric acid, fasting glucose, insulin, high sensitive CRP, and homeostasis model assessment for insulin resistance (HOMA-IR) were also assessed. Subjects were divided into 4 groups: A group, WC within normal range; B group, increased WC; C group, increased WC plus any one of the following individual factors of hypertension, dyslipidemia (low high-density lipoprotein-cholesterol and/or high triglyceride), and raised fasting glucose; D group, metabolic syndrome. Results: Compared with the A group, LA diameter, mass/volume ratio, HOMA-IR, and uric acid were greater in the B group (p<0.05 for all). With increasing number of metabolic syndrome disorders (C and D groups), dyslipidemia, increased Hs-CRP, decreased Em/Am, enhanced LA systolic force, increased IMT, and aortic stiffening were observed (Table). Conclusions: Higher WC is associated with insulin resistance, hyperuricemia, and concentric LV hypertrophy. Cardiovascular structural and functional changes become apparent with increasing number of metabolic syndrome disorders. Our findings suggest that primary prevention programs should be initiated in children with increased WC.

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Triglyceride Glucose-Waist Circumference Better Predicts Coronary Calcium Progression Compared with Other Indices of Insulin Resistance: A Longitudinal Observational Study

Journal of Clinical Medicine ◽

10.3390/jcm10010092 ◽

2020 ◽

Vol 10 (1) ◽

pp. 92

Author(s):

Yun Kyung Cho ◽

Jiwoo Lee ◽

Hwi Seung Kim ◽

Eun Hee Kim ◽

Min Jung Lee ◽

...

Keyword(s):

Insulin Resistance ◽

Waist Circumference ◽

Area Under The Curve ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

Tyg Index ◽

Longitudinal Observational Study ◽

Potential Marker ◽

Reliable Marker ◽

Better Than

The triglyceride glucose (TyG) index, a product of triglyceride and fasting glucose, is a reliable marker for insulin resistance. We aimed to investigate the association between the TyG-related markers and coronary artery calcification (CAC) progression. We enrolled 1145 asymptomatic participants who underwent repeated CAC score measurements during routine health examinations. Homeostasis model assessment of insulin resistance (HOMA-IR), TyG index, TyG-BMI (body mass index), and TyG-WC (waist circumference) were calculated. Progression of CAC was defined as (1) incident CAC in a CAC-free population, or an (2) increase of ≥2.5 units between the baseline and final square root of the CAC scores in participants with detectable CAC. According to the quartiles of parameters, we stratified the subjects into four groups. The prevalence of progression increased with the TyG-WC quartile (15.0%, 24.1%, 31.0%, and 32.2% for each of the groups; p < 0.001). The multivariate-adjusted odds ratio (95% confidence interval) for CAC score progression was 1.66 (1.01–2.77) when the highest and lowest TyG-WC index quartiles were compared. Furthermore, the predictability of TyG-WC for CAC progression was better than the other indices in terms of the area under the curve. The TyG-WC index predicted CAC progression better than other indices and could be a potential marker of future coronary atherosclerosis.

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Physical Activity and Insulin Resistance in 6,500 NHANES Adults: The Role of Abdominal Obesity

Journal of Obesity ◽

10.1155/2020/3848256 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

James R. Fowler ◽

Larry A. Tucker ◽

Bruce W. Bailey ◽

James D. LeCheminant

Keyword(s):

Physical Activity ◽

Insulin Resistance ◽

Waist Circumference ◽

Abdominal Obesity ◽

Total Activity ◽

Effect Modification ◽

Activity Level ◽

The Other ◽

Model Assessment ◽

The Relationship

This cross-sectional investigation studied differences in insulin resistance across levels of physical activity in 6,500 US adults who were randomly selected as part of the National Health and Nutrition Examination Survey (NHANES). Another important objective was to determine the influence of abdominal obesity on the physical activity and insulin resistance relationship. MET-minutes were utilized to quantify total activity based on participation in 48 different physical activities. Two strategies were employed to categorize levels of physical activity: one was based on relative MET-minutes (quartiles), and the other approach was based on the US physical activity guidelines. Insulin resistance was indexed using the homeostatic model assessment (HOMA). Abdominal obesity was indexed using waist circumference. Effect modification was tested by dividing waist circumferences into sex-specific quartiles and then evaluating the relationship between physical activity and HOMA-IR within each quartile separately. Results showed that relative physical activity level was associated with HOMA-IR after controlling for demographic and demographic and lifestyle covariates (F = 11.5, P<0.0001 and F = 6.0, P=0.0012, respectively). Adjusting for demographic and demographic and lifestyle covariates also resulted in significant relationships between guideline-based activity and HOMA-IR (F = 8.0, P<0.0001 and F = 4.9, P=0.0017, respectively). However, statistically controlling for differences in waist circumference with the other covariates nullified the relationship between total physical activity and HOMA-IR. Effect modification testing showed that when the sample was delimited to adults with abdominal obesity (Quartile 4), relative (F = 5.6, P=0.0019) and guideline-based physical activity (F = 3.7, P=0.0098) and HOMA-IR were significantly associated. Physical activity and HOMA-IR were not related within the other three quartiles. In conclusion, it appears that differences in physical activity may play a meaningful role in insulin resistance in those with abdominal obesity, but total activity does not seem to account for differences in insulin resistance among US adults with smaller waists.

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