Wrist circumference as a novel predictor of transition from metabolically healthy to unhealthy phenotype in overweight/obese adults: a gender-stratified 15.5-year follow-up

Background Individuals with transition from metabolically healthy overweight/obese (MHO) to metabolically unhealthy overweight/obese (MUO) phenotype are significantly predisposed to greater risks of cardiovascular events compared to those with a persistent MHO phenotype. The aim of this study was to evaluate the predictive performance of wrist circumference for this transition in adults over a 15.5-year follow-up. Methods We included 309 males and 821 females with the age of ≥18 years old, body mass index ≥25 kg/m2, and metabolically healthy status according to the criteria of the Joint Interim Statement. The incidence of MUO phenotype was evaluated for each gender, across tertiles wrist circumference, using Cox-proportional hazard models. Results The overall rate of transition from MHO to MUO phenotype was 87.1% in males and 77.5% in females. The hazard ratios (HRs) with 95% CI across second and third tertiles of wrist circumference were 0.89 (0.64-1.24) and 1.31 (0.99-1.73) in men (P for trend =0.027); and 1.34 (1.09-1.66) and 1.61 (1.30-2.00) in women (P for trend <0.001), respectively. After multivariable adjustment, HRs across second and third tertiles of wrist circumference were 0.92 (0.64-1.32) and 1.18 (0.83-1.67) in males (p for trend =0.352), and 1.32 (1.05-1.65) and 1.34 (1.06-1.96) in females (p for trend =0.025), respectively. Conclusions Wrist circumference significantly predicts the transition from MHO to MUO phenotype in adults of both genders. However, it is an independent predictor of the transition only in females. Future studies are warranted to clarify the role of wrist circumference mechanisms on metabolic risk deterioration.

Utility of wrist circumference in recognition of metabolic syndrome in overweight and obese South Indian children and adolescents

Objective To describe the utility of wrist circumference in the identification of cardiometabolic risk in overweight and obese children. Methods A cross-sectional study was conducted in the obesity clinic of a tertiary care referral hospital over a two year period. All children and adolescents aged 5–17 years with nutritional overweight and obesity were recruited. Data pertaining to chronological age, sex, risk factors and family history were collected. Clinical assessment of anthropometry: Weight, height, body mass index (BMI), Tanner’s stage, wrist circumference, blood pressure, waist circumference and triceps skinfold thickness done as per standard criteria. Biochemical assessment of blood glucose, serum insulin, lipid profile, and Homeostatic Model for Insulin Resistance performed after 12 h of fasting. Results We recruited 118 subjects (mean age 10.9 years, 71.1% males, 87.3% obese and 12.7% overweight); 30 (25.4%) had metabolic syndrome. The mean z scores of wrist circumference of children who presented with and without metabolic syndrome was 2.7 ± 0.8 and 2.1 ± 0.7, respectively (p<0.05). We observed a fair positive correlation between wrist circumference z score and BMI z score, (r=0.5; p<0.05). On receiver operating characteristic curve analysis, 97th percentile of wrist circumference predicted metabolic syndrome among overweight and obese children with a sensitivity of 86.7% and specificity of 37.5% (AUC=0.675). Conclusions Wrist circumference with 97th percentile as a cut-off is a useful tool to identify metabolic syndrome amongst overweight and obese children and adolescents.

Correlation between wrist circumference with blood pressure and creatinine level among elderly

Background: Hypertension is a highly prevalent health problem which incidence is greatest among the elderly. Hypertension may increase creatinine level and leads to other health problems like diabetes mellitus, kidney damage, and cardiovascular disease. Wrist circumference is a simple anthropometric measurement that can be used to identify hypertension and increasing level of serum creatinine.Objectives: To analyze the correlation of wrist circumference with blood pressure and creatinine level among the elderly.Materials and Methods: This was a cross-sectional study with a purposive sampling method. Subjects of this study were 84 women aged 60 years old or above at Unit Rehabilitasi Sosial Pucang Gading Semarang. The independent variable of this study was wrist circumference, and the dependent variables were systolic blood pressure, diastolic blood pressure, and creatinine level. The result was analyzed using the Spearman-rho test.Results: The participants of this research were 49% women aged 60-65 years old, with an average age was 65.5 years old. The prevalence of hypertension was 61.9%. Most hypertension incidence in this research was caused by high systolic blood pressure (50%), and the rest was caused by high diastolic blood pressure (3.9%) and both (46.1%). The level of creatinine was normal with an average level was 0.75 mg/dL. There was no correlation of wrist circumference with systolic blood pressure systolic (r=0.15; p=0.19), diastolic blood pressure (r=0.1; p=0.38), and creatinine serum (r=0.18; p=0.09) among elderly.Conclusions: There was no correlation of wrist circumference with blood pressure and creatinine level among the elderly.

Neck and Wrist Circumferences as Indicators of Metabolic Alterations in the Pediatric Population: A Scoping Review

Neck circumference (NC) and wrist circumference (WrC) have been proposed as practical and inexpensive tools with the capacity to indicate metabolic alterations to some extent. Nevertheless, their application in the pediatric population is relatively recent. Thus, the aim of this scoping review was to review and analyze the reported evidence regarding the correlation of NC and WrC with metabolic alterations in the pediatric stage. The literature search was performed in January 2021 in seven indexes and databases. A total of 26 articles published between 2011 and 2020 were included. Most significant results were grouped into three categories: serum lipid profile, glucose homeostasis, and blood pressure. The parameter that showed the most significant results regardless of the anthropometric indicator analyzed for association was blood pressure. In contrast, total cholesterol and LDL-cholesterol showed non-significant associations along with conflicting results. We conclude that the use of NC and WrC, in addition to other well-established indicators, could facilitate the identification of metabolic alterations, specifically in plasma insulin and blood pressure. In fact, further studies are required to address the potential use of NC and WrC as predictors of early metabolic alterations, especially in countries with a fast-growing prevalence in obesity.

DETERMINING NEW ANTHROPOMETRIC MARKERS FOR SCREENING TYPE 2 DM IN A CARIBBEAN REGION.

The prevalence of Diabetes Mellitus (DM) in the Caribbean is high. BMI has been criticized as a measure for predicting T2 DM development because it does not discern between fat mass and muscle mass, nor does it reect an individual's fat distribution. The primary objective of the study was to determine the association between Indices using height, waist, hip, thigh, arm, and wrist circumference (cm) with development of T2 DM by comparing it to existing markers in test subjects and assessing their feasibility as predictive indicators for the development of Type 2 DM. In a cross-sectional study, a total of 331 subjects were involved in the study utilizing health centers and health camps in St Kitts (West Indies). Height was measured using Stadiometer, Weight using a calibrated digital weighing scale. Waist, hip, thigh, arm, and wrist circumference (cm) was measured using calibrated tape. ABI (Arav Body Index) is measured using a ratio of Waist and Combined Thigh & Height, Thigh to waist ratio (TWR) and Wrist to arm ratio (WAR) was compared to WHtR, WHR and BMI. ABI had the highest AUROC value among the ve adiposity indices (0.803, 95% condence interval [CI], 0.755 to 0.851; 0.785, 95% CI, 0.735 to 0.835 for WHtR; WHtR (0.785), WTR (0.672), WAR (0.652) and BMI (0.626). The cutoff values for ABI were 0.43. Among subjects with ABI less than 0.42, 83.8% (129) did not have type 2 DM and ABI more than 0.48, 90.2 % (51) had T2 DM. Hence, higher ABI strongly correlates with development of T2 DM. We conclude that ABI could be a more reliable tool for identifying individuals at risk of developing type 2 DM. This will help at-risk individuals to take preventive measures like lifestyle modication.

Wrist Circumference-Dependent Upper Limit of Normal for the Cross-Sectional Area Is Superior Over a Fixed Cut-Off Value in Confirming the Clinical Diagnosis of Carpal Tunnel Syndrome

Introduction: In confirming the clinical diagnosis of carpal tunnel syndrome (CTS), ultrasonography (US) is the recommended first diagnostic test in The Netherlands. One of the most important parameters for an abnormal US result is an increase of the CSA of the median nerve at the carpal tunnel inlet. An earlier study showed that a wrist-circumference dependent cut-off for the upper limit of normal of this CSA might be superior to a fixed cut-off of 11 mm2. In this study we compared three ultrasonography (US) parameters in three large Dutch hospitals.Methods: Patients with a clinical suspicion of CTS and with reasonable exclusion of other causes of their symptoms were prospectively included. A total number of 175 patients were analysed. The primary goal was to compare the number of wrists with an abnormal US result while using a fixed cut-off of 11 mm2 (FC), a wrist circumference-dependent cut-off (y = 0.88 * x−4, where y = ULN and x = wrist circumference in centimetres; abbreviated as WDC), and an intraneural flow related cut-off (IFC).Results: The WDC considered more US examinations to be abnormal (55.4%) than the FC (50.3%) did, as well as the IFC (46.9%), with a statistically significant difference of p = 0.035 and p = 0.001, respectively. The WDC detected 12 abnormal median nerves while the FC did not, and 18 while the IFC did not. The wrist circumference of the patients of these subgroups turned out to be significantly smaller (p &lt; 0.001) when compared with the rest of the group.Conclusion: According to these study results, the wrist-circumference dependent cut-off value for the CSA of the median nerve at the wrist appears to have a higher sensitivity than either a fixed cut-off value of 11 mm2 or cut-off values based on intraneural flow, and may add most value in patients with a smaller wrist circumference.