Distribution of subcutaneous and intermuscular fatty tissue of the mid-thigh measured by MRI—A putative indicator of serum adiponectin level and individual factors of cardio-metabolic risk

Obesity and metabolic syndrome (MetS) are associated with hypoadiponectinemia. On the contrary, studies revealed correlations between the amount of subcutaneous adipose tissue (SAT) and higher serum adiponectin levels. Furthermore, independent association of intermuscular adipose tissue (IMAT) deposit in the thigh with cardiometabolic risk factors (including total blood cholesterol, low-density lipoprotein (LDL), and triglycerides), and decreased insulin sensitivity, as MetS components, are sufficiently described. The combined relationship of thigh IMAT and SAT with serum adiponectin, leptin levels, and cardiometabolic risk factors have not been investigated till date. Since both SAT and IMAT play a role in fat metabolism, we hypothesized that the distribution pattern of SAT and IMAT in the mid-thigh might be related to adiponectin, leptin levels, and serum lipid parameters. We performed adipose tissue quantification using magnetic resonance imaging (MRI) of the mid-thigh in 156 healthy volunteers (78 male/78 female). Laboratory measurements of lipid panel, serum adiponectin, and leptin levels were conducted. Total serum adiponectin level showed a significant correlation with the percentage of SAT of the total thigh adipose tissue (SAT/ (IMAT+SAT)) for the whole study population and in sex-specific analysis. Additionally, SAT/(IMAT+SAT) was negatively correlated with known cardiometabolic risk factors such as elevated total blood cholesterol, LDL, and triglycerides; but positively correlated with serum high-density lipoprotein. In multiple linear regression analysis, (SAT/(IMAT+SAT)) was the most strongly associated variable with adiponectin. Interestingly, leptin levels did not show a significant correlation with this ratio. Adipose tissue distribution in the mid-thigh is not only associated to serum adiponectin levels, independent of sex. This proposed quantitative parameter for adipose tissue distribution could be an indicator for individual factors of a person`s cardiometabolic risk and serve as additional non-invasive imaging marker to ensure the success of lifestyle interventions.

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Relationship Between Meeting 24-Hour Movement Guidelines and Cardiometabolic Risk Factors in Children

Journal of Physical Activity and Health ◽

10.1123/jpah.2017-0090 ◽

2017 ◽

Vol 14 (10) ◽

pp. 779-784 ◽

Cited By ~ 19

Author(s):

Peter T. Katzmarzyk ◽

Amanda E. Staiano

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Blood Pressure ◽

Adipose Tissue ◽

Subcutaneous Adipose Tissue ◽

Cardiometabolic Risk ◽

Vigorous Physical Activity ◽

Density Lipoprotein ◽

Cardiometabolic Risk Factors ◽

Subcutaneous Adipose

Background:The purpose of this study was to evaluate the relationship between adherence to pediatric 24-hour movement guidelines (moderate to vigorous physical activity, sedentary behavior, and sleep) and cardiometabolic risk factors.Methods:The sample included 357 white and African American children aged 5–18 years. Physical activity, television viewing, and sleep duration were measured using questionnaires, and the 24-hour movement guidelines were defined as ≥60 minutes per day of moderate to vigorous physical activity on ≥5 days per week, ≤ 2 hours per day of television, and sleeping 9–11 hours per night (ages 5–13 y) or 8–10 hours per night (ages 14–18 y). Waist circumference, body fat, abdominal visceral and subcutaneous adipose tissue, blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, and glucose were measured in a clinical setting.Results:A total of 26.9% of the sample met none of the guidelines, whereas 36.4%, 28.3%, and 8.4% of the sample met 1, 2, or all 3 guidelines, respectively. There were significant associations between the number of guidelines met and body mass index, visceral and subcutaneous adipose tissue, triglycerides, and glucose. There were no associations with blood pressure or high-density lipoprotein cholesterol.Conclusions:Meeting more components of the 24-hour movement guidelines was associated with lower levels of obesity and several cardiometabolic risk factors. Future efforts should consider novel strategies to simultaneously improve physical activity, sedentary time, and sleep in children.

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Assessment of the correlation between the atherogenic index of plasma and cardiometabolic risk factors in children and adolescents: might it be superior to the TG/HDL-C ratio?

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2016-0479 ◽

2017 ◽

Vol 30 (9) ◽

Cited By ~ 4

Author(s):

Nalan Hakime Nogay

Keyword(s):

Risk Factors ◽

Children And Adolescents ◽

Strong Correlation ◽

Cardiometabolic Risk ◽

Density Lipoprotein ◽

Cardiometabolic Risk Factors ◽

Atherogenic Index ◽

Fasting Period ◽

Atherogenic Index Of Plasma ◽

The Mean

AbstractBackground:Most of the studies investigating the correlation between the atherogenic index of plasma (AIP) and cardiometabolic risk factors have been conducted with adults, while only a limited number of related studies that involved children and adolescents has been conducted. The purpose of this study is to assess the correlation between the AIP and other cardiometabolic risk factors in adolescents.Methods:This study was conducted with 310 girls and 90 boys who were between the ages of 6 and 18 years. After a 10-h fasting period, the biochemical values of the participants were measured in the morning. The anthropometric measurements of the participants were also taken. The AIP was calculated as Log10 (triglycerides/high density lipoprotein-cholesterol; TG/HDL-C).Results:In adolescents between the ages of 12 and 18, the mean AIP of the group with TG ≥130 mg/dL was significantly higher than that of the groups with TG of 90–129 mg/dL and <90 mg/dL. There was a strong correlation between TG and AIP for both boys and girls among the children and adolescents, while there was a strong correlation between the TG/HDL-C ratio and TG only in the boys who were within the 6–11-year-old age group.Conclusions:An increase in AIP is associated with cardiovascular risk factors in children and adolescents other than those seen in adults. Based on the TG/HDL-C ratio, the AIP may be superior as a complementary index in the assessment of cardiometabolic risks in children and adolescents.

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Factorial Analysis of the Cardiometabolic Risk Influence on Redox Status Components in Adult Population

Oxidative Medicine and Cellular Longevity ◽

10.1155/2021/6661940 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Aleksandra Klisic ◽

Nebojsa Kavaric ◽

Sanja Vujcic ◽

Vesna Spasojevic-Kalimanovska ◽

Jelena Kotur-Stevuljevic ◽

...

Keyword(s):

Risk Factors ◽

Cardiometabolic Risk ◽

Adult Population ◽

Density Lipoprotein ◽

Principal Component ◽

Cardiometabolic Risk Factors ◽

Binary Logistic Regression Analysis ◽

Visceral Adiposity Index ◽

Related Factor ◽

Compensatory Mechanism

Different byproducts of oxidative stress do not always lead to the same conclusion regarding its relationship with cardiometabolic risk, since controversial results are reported so far. The aim of the current study was to examine prooxidant determinant ((prooxidant-antioxidant balance (PAB)) and the marker of antioxidant defence capacity (total sulphydryl groups (tSHG)), as well as their ratio (PAB/tSHG) in relation to different cardiometabolic risk factors in the cohort of adult population. Additionally, we aimed to examine the joint effect of various cardiometabolic parameters on these markers, since to our knowledge, there are no studies that investigated that issue. A total of 292 participants underwent anthropometric measurements and venipuncture procedure for cardiometabolic risk factors assessment. Waist-to-height ratio (WHtR), body mass index, visceral adiposity index (VAI), and lipid accumulation product (LAP) were calculated. Principal component analysis (PCA) grouped various cardiometabolic risk parameters into different factors. This analysis was used in the subsequent binary logistic regression analysis to estimate the predictive potency of the factors towards the highest PAB and tSHG values. Our results show that triglycerides, VAI, and LAP were positively and high density lipoprotein cholesterol (HDL-c) were negatively correlated with tSHG levels and vice versa with PAB/tSHG index, respectively. On the contrary, there were no independent correlations between each cardiometabolic risk factor and PAB. PCA revealed that obesity-renal function-related factor (i.e., higher WHtR, but lower urea and creatinine) predicts both high PAB ( OR = 1.617 , 95% CI (1.204-2.171), P < 0.01 ) and low tSHG values ( OR = 0.443 , 95% CI (0.317-0.618), P < 0.001 ), while obesity-dyslipidemia-related factor (i.e., lower HDL-c and higher triglycerides, VAI, and LAP) predicts high tSHG values ( OR = 2.433 , 95% CI (1.660-3.566), P < 0.001 ). In conclusion, unfavorable cardiometabolic profile was associated with higher tSHG values. Further studies are needed to examine whether increased antioxidative capacity might be regarded as a compensatory mechanism due to free radicals’ harmful effects.

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Pengaruh Pemberian Alpukat Terhadap Kadar Kolesterol Total Darah Pada Mahasiswa/i Obesitas Di Fakultas Kedokteran Universitas HKBP Nommensen Medan Tahun 2019

Nommensen Journal of Medicine ◽

10.36655/njm.v6i2.240 ◽

2021 ◽

Vol 6 (2) ◽

pp. 40-43

Author(s):

Syupiarni Putri Waruwu ◽

Joseph Partogi Sibarani ◽

Saharnauli Janna Verawaty Simorangkir

Keyword(s):

Total Cholesterol ◽

Cholesterol Level ◽

Density Lipoprotein ◽

The Body ◽

Blood Cholesterol ◽

Ldl Oxidation ◽

Blood Cholesterol Level ◽

Total Blood ◽

Cholesterol Levels ◽

Total Blood Cholesterol

Background: Cholesterol is a fat that does not dissolve easily in the blood. Most of the cholesterol in the blood is attached to specific protein carriers in the plasma in the form of lipoprotein complexes, which are soluble in water. Lipoprotein which carries cholesterol throughout the body. namely LDL (Low Density Lipoprotein) and HDL (High Density Lipoprotein). An increase in LDL in the body tends to form atherosclerosis. In contrast HDL cholesterol inhibits LDL oxidation so that atherosclerotic plaque formation does not occur. Obesity is one of the risk factors for atherosclerosis with manifestations of coronary heart disease. Handling of obesity has been done by many researchers and implemented. One ingredient from nature that serves as an alternative ingredient to lower blood cholesterol levels is avocado. Objective: To determine the effect of avocado administration on total blood cholesterol levels in the obese college students at the Medical Faculty of Nommensen HKBP University in 2019. Methods :This research is a pre-experimental study with a pre-post test design in one group. The sample was selected by purposive sampling method and obtained 20 obese students. Subjects consumed avocado juice every day for 14 days. Total cholesterol levels were measured before (day 0) and after (day 14) treatment. Results: The mean total cholesterol level of the subject's blood on the pretest examination was 188.10 mg / dL and the posttest examination was 180.05 mg / dL. There was a decrease in the average total blood cholesterol level of 8.05 mg / dl. Paired T-test showed that there was a non-significant decrease in mean total blood cholesterol level with a value of p = 0.068 (p <0.05). Conclusion: In this study there was no effect of avocado administration on total blood cholesterol levels in obese students.

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Nutritional Status and Cardiometabolic Risk Factors in Institutionalized Adults with Cerebral Palsy

Medicina ◽

10.3390/medicina55050157 ◽

2019 ◽

Vol 55 (5) ◽

pp. 157 ◽

Cited By ~ 1

Author(s):

Aurora Norte ◽

Coral Alonso ◽

José Miguel Martínez-Sanz ◽

Ana Gutierrez-Hervas ◽

Isabel Sospedra

Keyword(s):

Risk Factors ◽

At Risk ◽

Cerebral Palsy ◽

Nutritional Status ◽

Cardiometabolic Risk ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Density Lipoprotein ◽

Cardiometabolic Risk Factors ◽

Lipoprotein Cholesterol

Background and Objectives: Cerebral palsy (CP) is a set of permanent disorders that limit physical activity and increase the risk of developing other diseases, such as metabolic syndrome (MS). Adequate nutrition can contribute to the prevention of associated symptoms. The main objective of this study is to evaluate the nutritional status and the prevalence of cardiometabolic risk factors in adults with CP and Gross Motor Function Classification System (GMFCS) levels between IV and V. Materials and Methods: A sample of 41 adults with CP and GMFCS levels from IV to V were studied. The variables used in the study were age, sex, weight, height, mean age, and GMFCS level range. To evaluate nutritional status, body mass index and the Mini Nutritional Assessment (MNA), a nutritional screening tool, were used. To assess cardiometabolic risk, data on obesity, central obesity, blood pressure, fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were collected. Results: More than 80% of the population studied was malnourished or at risk of malnutrition, according to the MNA tool classification ranges, and around 35% of the studied population was within the underweight range. Regarding cardiometabolic risk factors, only one adult with CP was diagnosed with MS. Conclusions: The studied population of adults with CP and GMFCS levels between IV and V is not a population at risk of MS; however, the high prevalence of malnutrition, as well as some of the most prevalent cardiovascular risk factors, should be taken into consideration.

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Adverse differences in cardiometabolic risk factor levels between individuals with pre-diabetes and normal glucose metabolism are more pronounced in women than in men: the Maastricht Study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000787 ◽

2019 ◽

Vol 7 (1) ◽

pp. e000787 ◽

Cited By ~ 3

Author(s):

Rianneke de Ritter ◽

Simone J S Sep ◽

Carla J H van der Kallen ◽

Miranda T Schram ◽

Annemarie Koster ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Pressure Difference ◽

Cardiometabolic Risk ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Cardiometabolic Risk Factors ◽

Blood Pressure Difference

ObjectiveTo investigate whether adverse differences in levels of cardiovascular risk factors in women than men, already established when comparing individuals with and without diabetes, are also present before type 2 diabetes onset.Research design and methodsIn a population-based cohort study of individuals aged 40-75 years (n=3410; 49% women, 29% type 2 diabetes (oversampled by design)), we estimated associations with cardiometabolic and lifestyle risk factors of (1) pre-diabetes and type 2 diabetes (reference category: normal glucose metabolism) and (2) among non-diabetic individuals, of continuous levels of hemoglobin A1c (HbA1c). Age-adjusted sex differences were analyzed using linear and logistic regression models with sex interaction terms.ResultsIn pre-diabetes, adverse differences in cardiometabolic risk factors were greater in women than men for systolic blood pressure (difference, 3.02 mm Hg; 95% CI:−0.26 to 6.30), high-density lipoprotein (HDL) cholesterol (difference, −0.10 mmol/L; 95% CI: −0.18 to −0.02), total-to-HDL cholesterol ratio (difference, 0.22; 95% CI: −0.01 to 0.44), triglycerides (ratio: 1.11; 95% CI: 1.01 to 1.22), and inflammation markers Z-score (ratio: 1.18; 95% CI: 0.98 to 1.41). In type 2 diabetes, these sex differences were similar in direction, and of greater magnitude. Additionally, HbA1c among non-diabetic individuals was more strongly associated with several cardiometabolic risk factors in women than men: per one per cent point increase, systolic blood pressure (difference, 3.58 mm Hg; 95% CI: −0.03 to 7.19), diastolic blood pressure (difference, 2.10 mm Hg; 95% CI: −0.02 to 4.23), HDL cholesterol (difference, −0.09 mmol/L; 95% CI: −0.19 to 0.00), and low-density lipoprotein cholesterol (difference, 0.26 mmol/L; 95% CI: 0.05 to 0.47). With regard to lifestyle risk factors, no consistent pattern was observed.ConclusionOur results are consistent with the concept that the more adverse changes in cardiometabolic risk factors in women (than men) arise as a continuous process before the onset of type 2 diabetes.

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Association of Basal Metabolic Rate and Nutrients Oxidation with Cardiometabolic Risk Factors and Insulin Sensitivity in Sedentary Middle-Aged Adults

Nutrients ◽

10.3390/nu12041186 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1186

Author(s):

Francisco J. Amaro-Gahete ◽

Lucas Jurado-Fasoli ◽

Jonatan R. Ruiz ◽

Manuel J. Castillo

Keyword(s):

Risk Factors ◽

Insulin Sensitivity ◽

Lean Mass ◽

Basal Metabolic Rate ◽

Plasma Insulin ◽

Cardiometabolic Risk ◽

Density Lipoprotein ◽

Cardiometabolic Risk Factors ◽

Middle Aged ◽

Middle Aged Adults

This cross-sectional study aimed to examine the association of basal metabolic rate (BMR) and basal fat and carbohydrate oxidation (BFox and BCHox, respectively) with cardiometabolic risk factors and insulin sensitivity in sedentary middle-aged adults. A total of 71 healthy sedentary adults (37 women) aged 40–65 years participated in the current study. Data were collected during the baseline assessments of the FIT-AGEING randomized controlled trial. BMR was measured via indirect calorimetry, and BFox and BCHox estimated by stoichiometric equations. Blood pressure, glucose, insulin, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides plasma levels were selected as cardiometabolic risk factors and assessed following standard procedures. We observed positive associations of BMR with plasma insulin and the homeostatic model assessment of insulin resistance index (HOMA; all p < 0.05) which were attenuated or disappeared after controlling by sex, age, and/or lean mass. There were positive associations between BFox and the quantitative insulin sensitivity check index (QUICKI; p < 0.015), while negative associations were noted between BFox and plasma insulin and HOMA (p < 0.015). There was a significant negative association between BCHox with QUICKI (p < 0.01), whereas significant positive relationships were obtained when BCHox was associated with plasma insulin and HOMA (p < 0.01). These associations persisted in almost all cases when controlling by sex, age and/or lean mass. No further relationships were found when BMR, BFox, and BCHox were associated with other cardiometabolic risk factors. In conclusion, our study findings support that greater BFox and lower BCHox are related to improved insulin sensitivity, whereas BMR seems to be not associated with neither cardiometabolic risk nor insulin sensitivity in sedentary middle-aged adults. Further intervention studies are necessary to well-understand the physiological mechanism implied in this relationship.

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Abdominal visceral and subcutaneous adipose tissue and associations with cardiometabolic risk in Inuit, Africans and Europeans: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-038071 ◽

2020 ◽

Vol 10 (9) ◽

pp. e038071 ◽

Cited By ~ 1

Author(s):

Pernille Falberg Rønn ◽

Gregers Stig Andersen ◽

Torsten Lauritzen ◽

Dirk Lund Christensen ◽

Mette Aadahl ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Adipose Tissue ◽

Subcutaneous Adipose Tissue ◽

Cardiometabolic Risk ◽

Abdominal Fat ◽

Cardiometabolic Risk Factors ◽

Hepatic Insulin Resistance ◽

Cross Sectional ◽

Subcutaneous Adipose

ObjectivesAbdominal fat has been identified as a risk marker of cardiometabolic disease independent of overall adiposity. However, it is not clear whether there are ethnic disparities in this risk. We investigated the associations of visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) with cardiometabolic risk factors in three ethnic diverse populations of Inuit, Africans and Europeans.DesignCross-sectional pooled study.SettingGreenland, Kenya and Denmark.MethodsA total of 5113 participants (2933 Inuit, 1397 Africans and 783 Europeans) from three studies in Greenland, Kenya and Denmark were included. Measurements included abdominal fat distribution assessed by ultrasound, oral glucose tolerance test, hepatic insulin resistance, blood pressure and lipids. The associations were analysed using multiple linear regressions.ResultsAcross ethnic group and gender, an increase in VAT of 1 SD was associated with higher levels of hepatic insulin resistance (ranging from 14% to 28%), triglycerides (8% to 16%) and lower high-density lipoprotein cholesterol (HDL-C, −1.0 to −0.05 mmol/L) independent of body mass index. VAT showed positive associations with most of the other cardiometabolic risk factors in Inuit and Europeans, but not in Africans. In contrast, SAT was mainly associated with the outcomes in Inuit and Africans. Of notice was that higher SAT was associated with higher HDL-C in African men (0.11 mmol/L, 95% CI: 0.03 to 0.18) and with lower HDL-C in Inuit (−0.07 mmol/L, 95% CI: -0.12 to –0.02), but not in European men (−0.02 mmol/L, 95% CI: −0.09 to 0.05). Generally weaker associations were observed for women. Furthermore, the absolute levels of several of the cardiometabolic outcomes differed between the ethnic groups.ConclusionsVAT and SAT were associated with several of the cardiometabolic risk factors beyond overall adiposity. Some of these associations were specific to ethnicity, suggesting that ethnicity plays a role in the pathway from abdominal fat to selected cardiometabolic risk factors.

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Association of Free Sugars Intake with Cardiometabolic Risk Factors among Japanese Adults: The 2016 National Health and Nutrition Survey, Japan

Nutrients ◽

10.3390/nu12123624 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3624

Author(s):

Aya Fujiwara ◽

Emiko Okada ◽

Chika Okada ◽

Mai Matsumoto ◽

Hidemi Takimoto

Keyword(s):

Risk Factors ◽

Cholesterol Level ◽

Cardiometabolic Risk ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Cardiometabolic Risk Factors ◽

Nutrition Survey ◽

Free Sugars ◽

Health And Nutrition ◽

Japanese Adults

The relationship between free sugars intake and cardiometabolic risk factors is unclear in Japanese adults. This cross-sectional study aimed to investigate this association using data from the 2016 National Health and Nutrition Survey, Japan. The percentage of energy intake from free sugars was estimated based on the 1-day weighed dietary record data of Japanese men (n = 4071) and women (n = 5794) aged ≥ 20 years. Associations between free sugars intake and cardiometabolic risk factors, including body mass index (BMI), waist circumference (WC), systolic and diastolic blood pressures, glycated haemoglobin (HbA1c) level and levels of serum total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol, were investigated using linear regression and Dunnett’s test, with the lowest category of quartiles as a reference. After adjustment for potential confounding factors, free sugars intake was inversely associated with blood pressures (men only) and HDL-cholesterol level (both sexes) and positively associated with total-cholesterol level (women only) and LDL-cholesterol level (both sexes), whereas no association was observed for BMI, WC, and HbA1c level. This study identified both positive and inverse associations of free sugars intake with cardiometabolic risk factors in Japanese adults.

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Association between access to social service resources and cardiometabolic risk factors: a machine learning and multilevel modeling analysis

BMJ Open ◽

10.1136/bmjopen-2018-025281 ◽

2019 ◽

Vol 9 (3) ◽

pp. e025281 ◽

Cited By ~ 4

Author(s):

Seth A Berkowitz ◽

Sanjay Basu ◽

Atheendar Venkataramani ◽

Gally Reznor ◽

Eric W Fleegler ◽

...

Keyword(s):

Machine Learning ◽

Risk Factors ◽

Cardiometabolic Risk ◽

Learning Algorithm ◽

Density Lipoprotein ◽

Social Needs ◽

Cardiometabolic Risk Factors ◽

Secondary Outcome ◽

Haemoglobin A1c ◽

Cross Sectional

ObjectivesInterest in linking patients with unmet social needs to area-level resources, such as food pantries and employment centres in one’s ZIP code, is growing. However, whether the presence of these resources is associated with better health outcomes is unclear. We sought to determine if area-level resources, defined as organisations that assist individuals with meeting health-related social needs, are associated with lower levels of cardiometabolic risk factors.DesignCross-sectional.SettingData were collected in a primary care network in eastern Massachusetts in 2015.Participants and primary and secondary outcome measures123 355 participants were included. The primary outcome was body mass index (BMI). The secondary outcomes were systolic blood pressure (SBP), low-density lipoprotein (LDL) cholesterol and haemoglobin A1c (HbA1c). All participants were included in BMI analyses. Participants with hypertension were included in SBP analyses. Participants with an indication for cholesterol lowering were included in LDL analyses and participants with diabetes mellitus were included in HbA1c analyses. We used a random forest-based machine-learning algorithm to identify types of resources associated with study outcomes. We then tested the association of ZIP-level selected resource types (three for BMI, two each for SBP and HbA1c analyses and one for LDL analyses) with these outcomes, using multilevel models to account for individual-level, clinic-level and other area-level factors.ResultsResources associated with lower BMI included more food resources (−0.08 kg/m2per additional resource, 95% CI −0.13 to −0.03 kg/m2), employment resources (−0.05 kg/m2, 95% CI −0.11 to −0.002 kg/m2) and nutrition resources (−0.07 kg/m2, 95% CI −0.13 to −0.01 kg/m2). No area resources were associated with differences in SBP, LDL or HbA1c.ConclusionsAccess to specific local resources is associated with better BMI. Efforts to link patients to area resources, and to improve the resources landscape within communities, may help reduce BMI and improve population health.

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