In view of the fact that Asians have higher abdominal fat at lower levels of body mass index (BMI), measures of abdominal adiposity such as waist circumference (WC) and waist to hip ratio (WHR) were investigated as pr...In view of the fact that Asians have higher abdominal fat at lower levels of body mass index (BMI), measures of abdominal adiposity such as waist circumference (WC) and waist to hip ratio (WHR) were investigated as predictors of hypertension. Data on BMI, WC, WHR and blood pressure (BP) were recorded through a cross-sectional study on 419 urban adults (210 men and 209 women;aged 30-60 years) in Pune, India. Abdominal obesity was higher among women than men (35.9% vs. 32.4%). However, age adjusted mean systolic BP (124.3 ± 15.1 mmHg vs. 114.7 ± 17.2 mmHg), diastolic BP (82.9 ± 10.5 mmHg vs. 76.4 ± 10.7 mmHg) and prevalence of hypertension (34.3% vs. 21.5%) was significantly higher (p < 0.01) among men than among women. Although both WC and WHR increased with increase in BMI, correlation coefficient of BMI with WC was significantly (p < 0.01) higher than that with WHR in both sexes, suggesting that WC could be better for assessing adiposity. In men, odds ratio [OR (95% CI) = 2.19 (1.08-4.45)] for hypertension was significant (p < 0.05) only for those in highest tertile of WC while it was significant (p < 0.01) even in the middle tertile in case of women [8.24 (2.67-25.43) for higher and 5.71 (1.82-17.89) for middle tertile]. Optimal cutoff for identifying obesity and hypertension showed significant (p < 0.01) area under curve (AUC) and sensitivity for WC than WHR in both sexes. The risk cutoffs were lower compared to those proposed by the World Health Organization especially for men, but were comparable with reported Asian studies. Thus, it was evident that WC performed better than BMI and WHR for assessing the risk of hypertension and may be used as a simple, convenient and inexpensive screening tool in epidemiological studies.展开更多
Background: The prevalence of lifestyle diseases is increasing rapidly in Youths (17 - 25 yrs). Factors such as poor diet, little or no physical exercise, and smoking are major contributors to this increase. Lifestyle...Background: The prevalence of lifestyle diseases is increasing rapidly in Youths (17 - 25 yrs). Factors such as poor diet, little or no physical exercise, and smoking are major contributors to this increase. Lifestyle diseases in youths present a timeline challenge as disease duration is longer and financial burden more costly. Aim: To analyse and synthesize published literature on the prevalence of and risk factors associated with four lifestyle diseases—obesity, hypertension, diabetes and cancer—in university/college students worldwide. Results: The literature indicates that among lifestyle diseases in university/college students, overweight/obesity (Body Mass Index > 25 kg/m2) had the highest prevalence of 45.6% and duration of approximately 5 years. Cardiovascular diseases and hypertension had lower prevalence rates but prehypertension which lingers >4 years was at 32.0%. Type 1 diabetes mellitus (T1DM) had a fairly high prevalence in college students (21.7%);type 2 diabetes mellitus (T2DM) was found in much lower percentage (12.95%). Cancer had the lowest prevalence of >2% but was increasing in most regions based on the presence of multiple risk factors. Conclusion: Increase prevalence of these diseases in youths indicates that young people are at high risk of developing these diseases due to poor early lifestyle habits. Early corrective measures can reduce the burden of many lifestyle diseases.展开更多
Objective Waist circumference, waist-to-hip ratio and waist-to-height ratio, which are the indicators or measures of abdominal adiposity, have long been hypothesized to increase the risk of stroke; yet evidence accumu...Objective Waist circumference, waist-to-hip ratio and waist-to-height ratio, which are the indicators or measures of abdominal adiposity, have long been hypothesized to increase the risk of stroke; yet evidence accumulated till date is not conclusive. Here, we conducted a dose-response meta-analysis to summarize evidences of the association between these measures of abdominal adiposity and the risk of stroke. Methods PubMed and Web of Science databases were searched from inception to May 2015. Two investigators independently conducted the study selection and data extraction. Dose-response relationships were assessed by the generalized least squares trend estimation, while the summary effect estimates were evaluated by the use of fixed- or random-effect models. Subgroup and sensitivity analyses were performed to assess the potential sources of heterogeneity and the robustness of the pooled estimation. Publication bias of the literature was evaluated using Begg's and Egger's test. Results Altogether 15 prospective cohort studies were identified in this study. The summary of relative risks (95% confidence intervals) of stroke for the highest versus the lowest categories was 1.28 (1.18-1.40) for waist circumference, 1.32 (1.21-1.44) for waist-to-hip ratio, and 1.49 (1.24-1.78) for waist-to-height ratio. For a 10-cm increase in waist circumference, the relative risk of stroke increased by 10%; for a 0.1-unit increase in waist-to-hip ratio, the relative risk increased by 16%; and for a 0.05-unit increase in waist-to-height ratio, the relative risk increased by 13%. There was evidence of a nonlinear association between waist-to-hip ratio and stroke risk, Pnonlinearity=0.028, Conclusion Findings from our meta-analysis indicated that waist circumference, waist-to-hip ratio, and waist-to-height ratio were positively associated with the risk of stroke, particularly ischemic stroke.展开更多
Background: Obesity is associated with higher end-stage renal disease incidence, but associations with earlier forms of kidney disease remain incompletely characterized. Methods: We studied the association of body mas...Background: Obesity is associated with higher end-stage renal disease incidence, but associations with earlier forms of kidney disease remain incompletely characterized. Methods: We studied the association of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with rapid kidney function decline and incident chronic kidney disease in 4573 non-diabetic adults with eGFR ≥ 60 ml/min/1.73m2 at baseline from longitudinal Multi-Ethnic Study of Atherosclerosis cohort. Kidney function was estimated by creatinine and cystatin C. Multivariate analysis was adjusted for age, race, baseline eGFR, and hypertension. Results: Mean age was 60 years old, BMI 28 kg/m2, baseline eGFRCr 82 and eGFRCys 95 ml/min/1.73m2. Over 5 years of follow up, 25% experienced rapid decline in renal function by eGFRCr and 22% by eGFRCys. Incident chronic kidney disease (CKD) developed in 3.3% by eGFRCys, 11% by eGFRCr, and 2.4% by both makers. Compared to persons with BMI 25, overweight (BMI 25 - 30) persons had the?lowest risk of rapid decline by eGFRCr (0.84, 0.71 - 0.99). In contrast, higher BMI categories were associated with stepwise higher odds of rapid decline by eGFRCys, but remained significant only when BMI ≥ 35 kg/m2 (1.87, 1.41 - 2.48). Associations of BMI with incident CKD were insignificant after adjustment. Large WC and WHR were associated with increased risk of rapid decline only by eGFRCys, and of incident CKD only when defined by both filtration markers. Conclusions: Obesity may be a risk factor for kidney function decline, but associations vary by filtration marker used.展开更多
目的:探讨肥胖与青少年腰椎间盘突出症发病关系。方法:2018年1月至2019年7月经排除标准筛选后,581例接受手术治疗的腰椎间盘突出症患者纳入研究,其中男337例,女244例。按照联合国世界卫生组织对年龄的划分标准将其分为两组,青少年组235...目的:探讨肥胖与青少年腰椎间盘突出症发病关系。方法:2018年1月至2019年7月经排除标准筛选后,581例接受手术治疗的腰椎间盘突出症患者纳入研究,其中男337例,女244例。按照联合国世界卫生组织对年龄的划分标准将其分为两组,青少年组235例,男145例,女90例,年龄14~44(32.2±7.3)岁;中老年组346例,男192例,女154例,年龄45~85(58.7±9.8)岁。入院时由同一名经过培训的调查员用卷尺测量身高、腰围、臀围,电子称测量体重。所有数据测量2次取平均值。计算得出体重指数(body mass index,BMI)和腰臀比。根据各个参数标准将患者分为正常、超重、肥胖,计算不同年龄组各个参数肥胖者的比例,并进行统计学分析。结果:青少年患者中BMI、腰围、腰臀比正常者分别为78例(33.2%),91例(38.7%),85例(36.2%);超重者分别为104例(44.3%),95例(40.4%),99例(42.1%);肥胖者分别为53例(22.5%),49例(20.9%),51例(21.7%)。中老年患者BMI、腰围、腰臀比正常者分别为145例(41.9%),138例(39.9%),147例(42.5%);超重者分别为153例(44.2%),162例(46.8%),155例(44.8%);肥胖者分别为48例(13.9%),46例(13.3%),44例(12.7%)。青少年组3个参数中肥胖者比例均高于中老年组(P<0.05)。结论:肥胖可能额外增加了青少年腰椎间盘的负荷,加速了腰椎退变,对于青少年来说肥胖是腰椎间盘突出症更为显著的危险因素,因此在青少年中控制体重、预防肥胖对减少腰椎间盘突出症的发生率更为重要。展开更多
文摘In view of the fact that Asians have higher abdominal fat at lower levels of body mass index (BMI), measures of abdominal adiposity such as waist circumference (WC) and waist to hip ratio (WHR) were investigated as predictors of hypertension. Data on BMI, WC, WHR and blood pressure (BP) were recorded through a cross-sectional study on 419 urban adults (210 men and 209 women;aged 30-60 years) in Pune, India. Abdominal obesity was higher among women than men (35.9% vs. 32.4%). However, age adjusted mean systolic BP (124.3 ± 15.1 mmHg vs. 114.7 ± 17.2 mmHg), diastolic BP (82.9 ± 10.5 mmHg vs. 76.4 ± 10.7 mmHg) and prevalence of hypertension (34.3% vs. 21.5%) was significantly higher (p < 0.01) among men than among women. Although both WC and WHR increased with increase in BMI, correlation coefficient of BMI with WC was significantly (p < 0.01) higher than that with WHR in both sexes, suggesting that WC could be better for assessing adiposity. In men, odds ratio [OR (95% CI) = 2.19 (1.08-4.45)] for hypertension was significant (p < 0.05) only for those in highest tertile of WC while it was significant (p < 0.01) even in the middle tertile in case of women [8.24 (2.67-25.43) for higher and 5.71 (1.82-17.89) for middle tertile]. Optimal cutoff for identifying obesity and hypertension showed significant (p < 0.01) area under curve (AUC) and sensitivity for WC than WHR in both sexes. The risk cutoffs were lower compared to those proposed by the World Health Organization especially for men, but were comparable with reported Asian studies. Thus, it was evident that WC performed better than BMI and WHR for assessing the risk of hypertension and may be used as a simple, convenient and inexpensive screening tool in epidemiological studies.
文摘Background: The prevalence of lifestyle diseases is increasing rapidly in Youths (17 - 25 yrs). Factors such as poor diet, little or no physical exercise, and smoking are major contributors to this increase. Lifestyle diseases in youths present a timeline challenge as disease duration is longer and financial burden more costly. Aim: To analyse and synthesize published literature on the prevalence of and risk factors associated with four lifestyle diseases—obesity, hypertension, diabetes and cancer—in university/college students worldwide. Results: The literature indicates that among lifestyle diseases in university/college students, overweight/obesity (Body Mass Index > 25 kg/m2) had the highest prevalence of 45.6% and duration of approximately 5 years. Cardiovascular diseases and hypertension had lower prevalence rates but prehypertension which lingers >4 years was at 32.0%. Type 1 diabetes mellitus (T1DM) had a fairly high prevalence in college students (21.7%);type 2 diabetes mellitus (T2DM) was found in much lower percentage (12.95%). Cancer had the lowest prevalence of >2% but was increasing in most regions based on the presence of multiple risk factors. Conclusion: Increase prevalence of these diseases in youths indicates that young people are at high risk of developing these diseases due to poor early lifestyle habits. Early corrective measures can reduce the burden of many lifestyle diseases.
基金supported by the National Natural Science Foundation of China(Grant no:81172761)by a Project of the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘Objective Waist circumference, waist-to-hip ratio and waist-to-height ratio, which are the indicators or measures of abdominal adiposity, have long been hypothesized to increase the risk of stroke; yet evidence accumulated till date is not conclusive. Here, we conducted a dose-response meta-analysis to summarize evidences of the association between these measures of abdominal adiposity and the risk of stroke. Methods PubMed and Web of Science databases were searched from inception to May 2015. Two investigators independently conducted the study selection and data extraction. Dose-response relationships were assessed by the generalized least squares trend estimation, while the summary effect estimates were evaluated by the use of fixed- or random-effect models. Subgroup and sensitivity analyses were performed to assess the potential sources of heterogeneity and the robustness of the pooled estimation. Publication bias of the literature was evaluated using Begg's and Egger's test. Results Altogether 15 prospective cohort studies were identified in this study. The summary of relative risks (95% confidence intervals) of stroke for the highest versus the lowest categories was 1.28 (1.18-1.40) for waist circumference, 1.32 (1.21-1.44) for waist-to-hip ratio, and 1.49 (1.24-1.78) for waist-to-height ratio. For a 10-cm increase in waist circumference, the relative risk of stroke increased by 10%; for a 0.1-unit increase in waist-to-hip ratio, the relative risk increased by 16%; and for a 0.05-unit increase in waist-to-height ratio, the relative risk increased by 13%. There was evidence of a nonlinear association between waist-to-hip ratio and stroke risk, Pnonlinearity=0.028, Conclusion Findings from our meta-analysis indicated that waist circumference, waist-to-hip ratio, and waist-to-height ratio were positively associated with the risk of stroke, particularly ischemic stroke.
文摘Background: Obesity is associated with higher end-stage renal disease incidence, but associations with earlier forms of kidney disease remain incompletely characterized. Methods: We studied the association of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with rapid kidney function decline and incident chronic kidney disease in 4573 non-diabetic adults with eGFR ≥ 60 ml/min/1.73m2 at baseline from longitudinal Multi-Ethnic Study of Atherosclerosis cohort. Kidney function was estimated by creatinine and cystatin C. Multivariate analysis was adjusted for age, race, baseline eGFR, and hypertension. Results: Mean age was 60 years old, BMI 28 kg/m2, baseline eGFRCr 82 and eGFRCys 95 ml/min/1.73m2. Over 5 years of follow up, 25% experienced rapid decline in renal function by eGFRCr and 22% by eGFRCys. Incident chronic kidney disease (CKD) developed in 3.3% by eGFRCys, 11% by eGFRCr, and 2.4% by both makers. Compared to persons with BMI 25, overweight (BMI 25 - 30) persons had the?lowest risk of rapid decline by eGFRCr (0.84, 0.71 - 0.99). In contrast, higher BMI categories were associated with stepwise higher odds of rapid decline by eGFRCys, but remained significant only when BMI ≥ 35 kg/m2 (1.87, 1.41 - 2.48). Associations of BMI with incident CKD were insignificant after adjustment. Large WC and WHR were associated with increased risk of rapid decline only by eGFRCys, and of incident CKD only when defined by both filtration markers. Conclusions: Obesity may be a risk factor for kidney function decline, but associations vary by filtration marker used.
文摘目的:探讨肥胖与青少年腰椎间盘突出症发病关系。方法:2018年1月至2019年7月经排除标准筛选后,581例接受手术治疗的腰椎间盘突出症患者纳入研究,其中男337例,女244例。按照联合国世界卫生组织对年龄的划分标准将其分为两组,青少年组235例,男145例,女90例,年龄14~44(32.2±7.3)岁;中老年组346例,男192例,女154例,年龄45~85(58.7±9.8)岁。入院时由同一名经过培训的调查员用卷尺测量身高、腰围、臀围,电子称测量体重。所有数据测量2次取平均值。计算得出体重指数(body mass index,BMI)和腰臀比。根据各个参数标准将患者分为正常、超重、肥胖,计算不同年龄组各个参数肥胖者的比例,并进行统计学分析。结果:青少年患者中BMI、腰围、腰臀比正常者分别为78例(33.2%),91例(38.7%),85例(36.2%);超重者分别为104例(44.3%),95例(40.4%),99例(42.1%);肥胖者分别为53例(22.5%),49例(20.9%),51例(21.7%)。中老年患者BMI、腰围、腰臀比正常者分别为145例(41.9%),138例(39.9%),147例(42.5%);超重者分别为153例(44.2%),162例(46.8%),155例(44.8%);肥胖者分别为48例(13.9%),46例(13.3%),44例(12.7%)。青少年组3个参数中肥胖者比例均高于中老年组(P<0.05)。结论:肥胖可能额外增加了青少年腰椎间盘的负荷,加速了腰椎退变,对于青少年来说肥胖是腰椎间盘突出症更为显著的危险因素,因此在青少年中控制体重、预防肥胖对减少腰椎间盘突出症的发生率更为重要。