scholarly journals Anthropometric cut-offs to identify hyperglycemia in an Afro-Caribbean population: a cross-sectional population-based study from Barbados

2021 ◽  
Vol 9 (1) ◽  
pp. e002246
Author(s):  
Alisha N Wade ◽  
Ian R Hambleton ◽  
Anselm J M Hennis ◽  
Christina Howitt ◽  
Selvi M Jeyaseelan ◽  
...  

IntroductionBody mass index (BMI) and waist circumference (WC) cut-offs associated with hyperglycemia may differ by ethnicity. We investigated the optimal BMI and WC cut-offs for identifying hyperglycemia in the predominantly Afro-Caribbean population of Barbados.Research design and methodsA cross-sectional study of 865 individuals aged ≥25 years without known diabetes or cardiovascular disease was conducted. Hyperglycemia was defined as fasting plasma glucose ≥5.6 mmol/L or hemoglobin A1c ≥5.7% (39 mmol/mol). The Youden index was used to identify the optimal cut-offs from the receiver operating characteristic (ROC) curves. Further ROC analysis and multivariable log binomial regression were used to compare standard and data-derived cut-offs.ResultsThe prevalence of hyperglycemia was 58.9% (95% CI 54.7% to 63.0%). In women, optimal BMI and WC cut-offs (27 kg/m2 and 87 cm, respectively) performed similarly to standard cut-offs. In men, sensitivities of the optimal cut-offs of BMI ≥24 kg/m2 (72.0%) and WC ≥86 cm (74.0%) were higher than those for standard BMI and WC obesity cut-offs (30.0% and 25%–46%, respectively), although with lower specificity. Hyperglycemia was 70% higher in men above the data-derived WC cut-off (prevalence ratio 95% CI 1.2 to 2.3).ConclusionsWhile BMI and WC cut-offs in Afro-Caribbean women approximate international standards, our findings, consistent with other studies, suggest lowering cut-offs in men may be warranted to improve detection of hyperglycemia. Our findings do, however, require replication in a new data set.

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017966 ◽  
Author(s):  
Maria Elizete A Araujo ◽  
Marcus T Silva ◽  
Tais F Galvao ◽  
Mauricio G Pereira

ObjectivesTo estimate the prevalence of healthcare use and associated factors in the Manaus metropolitan region and to describe the reasons for lack of access.DesignCross-sectional population-based study.SettingA survey conducted between May and August of 2015 in eight cities from Manaus metropolitan region, Amazonas, Brazil.Participants4001 adults ≥18 years of age.Primary outcomes measuresPhysician visits, dentist visits and hospitalisations in the last 12 months were the primary outcomes. Associated factors were investigated through the calculation of prevalence ratio (PR) obtained by hierarchical Poisson regression modelling.Results4001 adults were included in the study, 53% of whom were women. The self-reported prevalence of medical visits was 77% (95% CI 75% to 77%); dentist visits, 36% (95% CI 34% to 37%) and hospital admission, 7% (95% CI 6% to 7%). Physician visits were higher in women PR=1.18 (95% CI 1.14 to 1.23), the elderly PR=1.18 (95% CI 1.10 to 1.26) and people with health insurance PR=1.14 (95% CI 1.10 to 1.19). Dentist visits declined with older age PR=0.38 (95% CI 0.30 to 0.49), lower education level PR=0.62 (95% CI 0.51 to 0.74) and lower economic class PR=0.65 (95% CI 0.57 to 0.75). Hospitalisations were found to be twice as frequent for women than for men and three times as frequent among those who reported very poor health status. Among the individuals who did not receive medical attention in the previous 2 weeks, 58% reported lack of facilities or appointment unavailable and 14% reported lack of doctors.ConclusionWhile more than half visited the doctor in the last year, a lower proportion of people with socioeconomic inequities visited the dentist. Organisational and service policies are needed to increase equity in health services in the region.


2009 ◽  
Vol 13 (4) ◽  
pp. 488-495 ◽  
Author(s):  
Ahmet Selçuk Can ◽  
Emine Akal Yıldız ◽  
Gülhan Samur ◽  
Neslişah Rakıcıoğlu ◽  
Gülden Pekcan ◽  
...  

AbstractObjectiveTo identify the optimal waist:height ratio (WHtR) cut-off point that discriminates cardiometabolic risk factors in Turkish adults.DesignCross-sectional study. Hypertension, dyslipidaemia, diabetes, metabolic syndrome score ≥2 (presence of two or more metabolic syndrome components except for waist circumference) and at least one risk factor (diabetes, hypertension or dyslipidaemia) were categorical outcome variables. Receiver-operating characteristic (ROC) curves were prepared by plotting 1 − specificity on the x-axis and sensitivity on the y-axis. The WHtR value that had the highest Youden index was selected as the optimal cut-off point for each cardiometabolic risk factor (Youden index = sensitivity + specificity − 1).SettingTurkey, 2003.SubjectsAdults (1121 women and 571 men) aged 18 years and over were examined.ResultsAnalysis of ROC coordinate tables showed that the optimal cut-off value ranged between 0·55 and 0·60 and was almost equal between men and women. The sensitivities of the identified cut-offs were between 0·63 and 0·81, the specificities were between 0·42 and 0·71 and the accuracies were between 0·65 and 0·73, for men and women. The cut-off point of 0·59 was the most frequently identified value for discrimination of the studied cardiometabolic risk factors. Subjects classified as having WHtR ≥ 0·59 had significantly higher age and sociodemographic multivariable-adjusted odds ratios for cardiometabolic risk factors than subjects with WHtR < 0·59, except for diabetes in men.ConclusionsWe show that the optimal WHtR cut-off point to discriminate cardiometabolic risk factors is 0·59 in Turkish adults.


2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
U. Risérus ◽  
U. de Faire ◽  
L. Berglund ◽  
M.-L. Hellénius

Background. Waist girth and BMI are commonly used as markers of cardiometabolic risk. Accumulating data however suggest that sagittal abdominal diameter (SAD) or “abdominal height” may be a better marker of intra-abdominal adiposity and cardiometabolic risk. We aimed to identify cutoffs for SAD using a cardiometabolic risk score.Design. A population-based cross-sectional study.Methods. In 4032 subjects (1936 men and 2096 women) at age 60, different anthropometric variables (SAD, BMI, waist girth, and waist-to-hip ratio) were measured and cardiometabolic risk score calculated. ROC curves were used to assess cutoffs.Results. Among men SAD showed the strongest correlations to the majority of the individual risk factors; whereas in women SAD was equal to that of waist girth. In the whole sample, the area under the ROC curve was highest for SAD. The optimal SAD cutoff for an elevated cardiometabolic risk score in men was∼22 cm (95%CI; 21.6 to 22.8) and in women∼20 cm (95%CI; 19.4 to 20.8). These cutoffs were similar if the Framingham risk score was used.Conclusions. These cutoffs may be used in research and screening to identify “metabolically obese” men who would benefit from lifestyle and pharmacological interventions. These results need to be verified in younger age groups.


2007 ◽  
Vol 41 (1) ◽  
pp. 69-75 ◽  
Author(s):  
Mario Renato Azevedo ◽  
Cora Luiza Araújo ◽  
Marcelo Cozzensa da Silva ◽  
Pedro Curi Hallal

OBJECTIVE: To assess the association between regular physical activity in adolescence and leisure-time physical activity in adulthood, with emphasis on gender differences. METHODS: A population-based cross-sectional study was carried out in Pelotas, Southern Brazil, in 2003. A representative sample of households was selected in multiple stages and subjects aged 20-59 years were interviewed. Leisure-time physical activity was evaluated using the International Physical Activity Questionnaire. Data on adolescent physical activity were based on subjects' recall. RESULTS: Of 2,577 subjects interviewed, 27.5% were classified as adequately active, and 54.9% reported regular physical activity in adolescence. Subjects who engaged in regular physical activity during adolescence were more likely to be adequately active in adulthood (adjusted prevalence ratio 1.42; 95% CI: 1.23; 1.65). This effect was stronger in women (adjusted prevalence ratio: 1.51; 95% CI: 1.22; 1.86) than men (adjusted prevalence ratio: 1.35; 95% CI: 1.10; 1.67). CONCLUSIONS: Promoting physical activity in school age may be a successful intervention against the epidemic of adult inactivity. Although women were less likely to report regular physical activity in adolescence, the effect of this experience on adult behavior was stronger than in men.


2020 ◽  
Vol 4 (1) ◽  
pp. e000676
Author(s):  
Ikponmwosa Osaghae ◽  
Md Al-Amin Bhuiyan ◽  
Olakunle Alonge

ObjectiveTo determine the predictors of non-fatal violence or assault among adolescents in rural Bangladesh to inform evidence-based interventions.DesignCross-sectional study.SettingHousehold survey and national census in 51 unions of rural Bangladesh.Participants, methods and main outcome213 782 adolescents aged 11–19 years who reported violence during a population-based survey in 2013. We used logistic regression to determine the prevalence of factors that predict non-fatal forms of violence or assaults among adolescents. Assault or violence was defined as all injuries inflicted directly by another person or resulting from collateral impact over a 6-month recall period.Results457 (0.21%) cases of violence or assault were reported. The adjusted prevalence ratio (PR) of violence was lower among female adolescents compared with males (PR: 0.60, 95% CI 0.47 to 0.78, p<0.001). Compared with the lowest socioeconomic quintile, being in a higher quintile was associated with lower prevalence of violence, with a 39% decrease in the adjusted prevalence of violence among adolescents in highest compared with lowest socioeconomic index (PR: 0.61, 95% CI 0.44 to 0.84). The adjusted prevalence of violence in Chandpur and Comilla districts was 7.30 times and 7.27 times higher respectively than the prevalence of violence in Sirajganj (PR: 7.30, 95% CI 4.07 to 13.10 and PR: 7.27, 95% CI 3.56 to 14.84, respectively). There was no significant difference in the adjusted prevalence of violence occurring in school compared with home (PR: 1.19, 95% CI 0.85 to 1.69).ConclusionMale adolescents may be at an increased risk of suffering violence, and socioeconomic factors and place (districts) are strong predictors of adolescent violence among a selected population in rural Bangladesh. These findings are important in guiding interventions to address the burden of violence among adolescents in communities with similar demographics as our study population. Further research is needed to identify the actual burden of violence among adolescents at national level and to establish an effective violence prevention programme across Bangladesh.


2021 ◽  
Vol 39 ◽  
Author(s):  
Gustavo Magno Baldin Tiguman ◽  
Marina Borges Dias de Almeida ◽  
Marcus Tolentino Silva ◽  
Tais Freire Galvao

ABSTRACT Objective: The availability of hazardous products in households increases the risks of poisoning. The present study aimed to assess the frequency and associated factors of the availability and storage of hazardous products in residences in the metropolitan region of Manaus. Methods: Population-based and cross-sectional study conducted in 2015 with adults selected with three-stage probabilistic sampling. Participants were interviewed face-to-face. Prevalence ratio (PR) of the presence of hazardous products (presence of chumbinho [illegal anti-cholinesterase rodenticide], artisanal cleaning products, and unsafe storage of these products and medications) and 95% confidence intervals (95%CI) were calculated with Poisson regression with robust variance, weighted by the complex sampling method adopted. Results: A total of 4,001 participants was included, of which 53.0% (95%CI 51.5-54.6) reported presence of hazardous products in their households, 36.3% (95%CI 34.8-37.8) had unsafe storage, 16.2% (95%CI 15.1-17.4) had artisanal cleaning products, and 8.2% (95%CI 7.4-9.1) had chumbinho. Households with children ≤5 years old had safer storage (PR=0.78; 95%CI 0.71-0.86) and more artisanal products (PR=1.30; 95%CI 1.11-1.51). Presence of artisanal products was higher in lower educational levels (PR=2.20; 95%CI 1.36-3.57) and lower economic classifications (PR=1.63; 95%CI 1.25-2.13). Conclusions: Over half of the households in the metropolitan region of Manaus kept hazardous products; one-third stored them unsafely. Artisanal cleaning products and chumbinho were frequently present. Households with children had safer storage of products, and socioeconomic factors affected the availability of such hazardous products.


2020 ◽  
Author(s):  
Abel Lira ◽  
Nancy Vasconcelos ◽  
Tamara Santos ◽  
Luisa Duarte ◽  
Monica Assunção ◽  
...  

Abstract Background: African ancestry seems to be a risk factor for hypertension; however, few genetic studies have addressed this issue. This study aimed to investigate the prevalence of polymorphisms NOS3; rs1799983, IGFBP3; rs11977526 and TCF7L2; rs7903146 in Brazilian women of African descent and their association with hypertension.Methods: This is a cross-sectional study with a sample of 1021 women (19–59 years old) from the quilombola communities of Alagoas (Brazil). Demographic, socioeconomic, lifestyle, anthropometric, biochemical, and blood pressure data were collected. DNA was extracted from mucosa epithelial cells of the participants’ cheek. Genotyping was performed by PCR allelic discrimination. Prevalence ratio (PR) was the measure of association, calculated by Poisson regression, with a hierarchical selection of variables.Results: The prevalences of the less frequent genotypes were 26.5% TT genotype of NOS3; rs1799983, 16.7% AA genotype of IGFBP3; rs11977526, and 18.3% TT genotype of TCF7L2; rs7903146. For these conditions, the prevalence of hypertension and PR (adjusted) relatively to the ancestral genotype were, respectively: 52.0% vs 24.5% (PR=1.54; p<0.001), 62.0% vs 24.1% (PR=1.59; p<0.001), and 38.9% vs 27.9% (PR=0.86; p=0.166). Associations with hypertension were statistically significant, except for the TCF7L2; rs7903146 polymorphism, after adjusted analysis. Conclusions: Brazilian Afro-descendant women with the TT genotype for the NOS3 gene and the AA genotype for the IGFBP3 gene are more susceptible to hypertension. The understanding of underlying mechanisms involving the pathogenesis of hypertension can motivate research for the development of new therapeutic targets related to nitric oxide metabolism and the management of oxidative stress.


2021 ◽  
Vol 21 (2) ◽  
pp. 485-496
Author(s):  
Vanessa Gabrielle dos Santos Araújo ◽  
Tamara Rodrigues dos Santos ◽  
Ana Carolina Santana Vieira ◽  
Monica Lopes de Assunção ◽  
Haroldo da Silva Ferreira

Abstract Objectives: to investigate the prevalence of exclusive maternal breastfeeding (EMBF) and evaluate whether common mental disorder (CMD) and other predictors promote its early interruption (EI-EMBF4). Methods: a cross-sectional study involving all children <24 months (n=252) residing in 50% (n=34) of the Quilombola communities in Alagoas. The EI-EMBF4 was established when EMBF was ≤4 months. The Self-Reporting Questionnaire was used to identify the occurrence of CMD. Other predictors were obtained through interviews. The measure of association was the prevalence ratio calculated by the Poisson regression, following a hierarchical theoretical model. The prevalence of EMBF for 4 and 6 months, and its median duration (survival analysis) were calculated. Results: the prevalence of EI-EMBF4 and CMD was 57.6% and 42.9%, respectively. The risk factors independently associated with EI-EMBF4 were: living in a mud house, maternal age ≤18 years, low birth weight and the use of a pacifier or baby bottle. There was no association with CMD. The prevalence of EMBF for four and six months was 42.4% and 25.4%, respectively, and the median duration was 106 days. Conclusion: EMBF indicators are below the established recommendations, justifying the implementation of measures that prioritize women subjected to risk factors identified here. CMD is not configured among these.


Heart Asia ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. e011131 ◽  
Author(s):  
Bishal Gyawali ◽  
Shiva Raj Mishra ◽  
Salim S Virani ◽  
Per Kallestrup

BackgroundThe aim of this study was to assess the status of cardiovascular health among a semi-urban population of Nepal, and determine factors associated with ideal cardiovascular health.MethodsA population-based, cross-sectional study using a systematic random sample was conducted among 2310 adults aged ≥ 25 years in a semi-urban area of the Pokhara Metropolitan City previously named Lekthnath in Nepal. The ideal, intermediate and poor cardiovascular health were defined as the presence of 6–7, 4–5 or 1–3 health metrics, among a list of 7 health behaviours and healthfactors, namely smoking, body mass index, physical activity, fruits and vegetables intakes, harmful alcohol consumption, blood pressure, and fasting blood glucose. We used univariate and multivariate Poisson regression models adjusting for sex, age groups, ethnicity, educational level and socioeconomic status, and calculated the prevalence ratios with 95% CIs.ResultsOnly 14.3 % of the participants had ideal cardiovascular health, whereas 67.0% and 18.7% of the participants had intermediate and poor cardiovascular health, respectively. Age groups 45–54 years (prevalence ratio 0.88, 95% CI: 0.83 to 0.94, p<0.001) and 55–64 years (prevalence ratio 0.84, 95% CI: 0.79 to 0.90, p<0.001) were significantly associated with low prevalence of ideal cardiovascular health compared with the age group 35–44 years. Ethnic groups, including Janajati (prevalence ratio 0.89, 95% CI: 0.85 to 0.93, p<0.001) and Dalit (prevalence ratio 0.9, 95% CI: 0.84 to 0.95, p=0.001), were significantly associated with low prevalence of ideal cardiovascular health.ConclusionsPrevalence of ideal cardiovascular health is low in the semi-urban population in Nepal. Concerted efforts are needed to develop a population-based intervention to improve cardiovascular health in Nepal.


2016 ◽  
Vol 184 (9) ◽  
pp. 660-669 ◽  
Author(s):  
Valentina A. Andreeva ◽  
Valérie Deschamps ◽  
Benoît Salanave ◽  
Katia Castetbon ◽  
Charlotte Verdot ◽  
...  

Abstract Despite some advantages over traditional methods, Web-based studies elicit concerns about generalizability. To address this issue, we compared dietary intakes between an electronic (e-) cohort study and a nationally representative survey. We studied 49,443 French volunteers aged 18–74 years recruited during 2009–2010 in the NutriNet-Santé Study, a general population-based e-cohort study. The Etude Nationale Nutrition Santé (ENNS; 2006–2007), a cross-sectional study with a nationally representative sample of 2,754 French adults aged 18–74 years, served as the reference data set. Reported dietary intakes from three 24-hour dietary records were weighted and compared between the two studies via Student t tests for mean location, using a &gt;5% cutoff for establishing practically meaningful differences. We observed similar intakes as regards carbohydrates, total lipids, protein, and total energy. However, intakes of fruit and vegetables, fiber, vitamins B6, B9, C, D, and E, iron, and magnesium were higher in the e-cohort than in the ENNS, while intakes of alcohol and nonalcoholic beverages were lower in the e-cohort. Significant sex-specific differences were observed regarding vitamins A and B12, zinc, and potassium. True intake differences, mode effects, and volunteer bias might each contribute to explaining the findings. In the future, repeated use of the same tool in large e-cohorts with heterogeneous dietary exposures could serve research purposes and supplement group-level monitoring of dietary trends.


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