A Cross Sectional Study on the Correlation between Waist Circumference and Fatty Liver on Ultrasonography among Non-Alcoholic Filipino Adults

Objectives: This study aimed to determine the correlation between waist circumference and fatty liver on ultrasonography among non-alcoholic Filipino adults. This will aid in detecting non-alcoholic fatty liver disease in its early course, hence improving our current therapeutic recommendations in preventing and managing the adverse health outcomes of NAFLD. Methods and Materials: A cross-sectional study with a total of 65 recruited participants. The data collected were age, sex, waist-circumference, co-morbidities with maintenance medications, history of alcohol intake with emphasis on the quantity and duration, and history of drug intake. Waist circumference was measured and recorded. The presence of NAFLD was determined through a review of the ultrasonography results of all subjects. The demographic profile and waist circumference of all subjects were described using descriptive statistics. The chi-square test was utilized to test the independence of the NAFLD and WC in the quartile. Pearson correlation was used to determine the linear relationship between the variables. Pearson correlation coefficient was statistically significant at p 0.05. Results: Among the subjects, 26 (42%) presented with fatty liver based on ultrasonography, 15 (58%) and 11 (42%), males and females, respectively. The mean waist circumference of 97.5 ± 12.43 was significantly related to the fatty liver with a p-value of 0.0001. Waist circumference showed a positive correlation with the frequency of fatty liver on ultrasonography with p-values of 0.000755 (r = 0.590083) and 3.04366E—05 (r = 0.659143523), in males and females, correspondingly. The overall correlation between waist circumference and fatty liver on ultrasonography is statistically significant with a p-value of 4.10503E—08 (r = 0.634737127). Conclusion: One measure used to assess central obesity is waist circumference. In addition, it can also be utilized to assess risk for NAFLD since they are strongly correlated as reported in this study. Waist circumference cut-off values for the Filipinos proposed in this study are the following: >88 cm and >95 cm, in males and females, respectively.

Predictive Values of Body Mass Index and Waist Circumference for Risk Factors of Certain Related Diseases in Chinese Adults - Study on Optimal Cut-off Points of Body Mass Index and Waist Circumference in Chinese Adults

Objective For prevention of obesity in Chinese population, it is necessary to definethe optimal range of healthy weight and the appropriate cut-off points of BMI and waistcircumference for Chinese adults. The Working Group on Obesity in China under the supportof International Life Sciences Institute Focal Point in China organized a meta-analysis on therelation between BMI, waist circumference and risk factors of related chronic diseases (e. g.,high diabetes, diabetes mellitus, and lipoprotein disorders). Methods 13 population studiesin all met the criteria for enrollment, with data of 239 972 adults (20-70 year) surveyed inthe 1990s. Data on waist circumference was available for 111411 persons and data on serumlipids and glucose were available for more than 80 000. The study populations located in21provinces, municipalities and autonomous regions in China's Mainland as well as inTaiwan. Each enrolled study provided data according to a common protocol and uniformformat. The Center for data management in Department of Epidemiology, Fu Wai Hospitalwas responsible for statistical analysis. Results and conclusion The prevalence ofhypertension, diabetes, dyslipidemia and clustering of risk factors all increased withincreasing levels of BMI or waist circumference. BMI at 24 with best sensitivity andspecificity for identification of the risk factors, was recommended as the cut-off point foroverweight, BMI at 28 which may identify the risk factors with specificity around 90 % wasrecommended as the cut-off point for obesity. Waist circumference beyond 85 cm for menand beyond 80 cm for women were recommended as the cut-off points for central obesity.Analysis of population attributable risk percent illustrated that reducing BMI to normalrange (<24) could prevent 45%-50% clustering of risk factors. Treatment of obese persons(BMI≥28)with drugs could prevent 15%-17% clustering of risk factors. The waistcircumference controlled under 85 cm for men and under 80 cm for women, could prevent47%-58% clustering of risk factors. According to these, a classification of overweight andobesity for Chinese adults is recommended.

Waist Circumference Distribution of Chinese School-age Children and Adolescents

Background Waist circumference （WC）, a proxy measure of central body fat, is a better predictor than overall body fat for cardiovascular risk factors in both adults and children. WC cutoffs have been established in many countries, but the national WC reference has not been developed in China. Objective To study the distribution of WC in a representative group of Chinese children for establishing Chinese WC cutoff points. Methods Cross-sectional data obtained from 15 mainland provinces and Hong Kong were collected. There were 160 225 children and adolescents aged 7-18 years old in total. The subjects were divided into five regional groups namely costal city, other city, noah rural, south rural, and Hong Kong, for analyzing the distribution of WC. Results A large variation in WC distribution was found among the five groups for both sexes. Coastal city group had the highest P85 WC values consistently from the early school ages to 18-year-old compared with other groups. In contrast, south rural group had P85 values consistently lagged behind not only the city groups but also the north rural group. Hong Kong group had a high P85 WC at early ages, but because of the smaller increments of WC during adolescence, the P85 curve was gradually exceeded by the north rural groups. Catch-up trend was found in the two rural groups since the peak of puberty. These disparities were caused by not only socioeconomic and urban-rural factors but also north-south differences. Because of the regional variation of WC, a ＂gradient＂ prevalence of central obesity was prospected among these groups. Comparisons of WC distributions between the Chinese and the U.S.A or Netherlands demonstrated the necessary of setting up China＇s own WC cutoffs. Sex and age-specific percentiles were obtained and smoothed by using LMS method. Conclusion The data obtained from this study could be used to develop national WC cutoff points for Chinese children and adolescents.

Waist Circumference Reference Values for Screening Cardiovascular Risk Factors in Chinese Children and Adolescents

Objectives To explore the optimal threshold values of waist circumference （WC） for detecting cardiovascular （CV） risk factors among Chinese children and adolescents. Methods Association of WC with CV risk factors was studied among 65 898 children aged 7-18 years whose data were pooled from nine previous studies in China. CV risk factors in this study included hypertension （blood pressure above 95 percentile levels）, dyslipidemia （with one or more of the following three indexes： TG ≥ 1.7 mmol/L, TC ≥ 5.18 mmol/L, and HDL-C ≤ 1.04 mmol/L） and elevated glucose level （fasting plasma glucose ≥5.6 mmol/L）. Receive-operating characteristic analysis （ROC） and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting CV risk factors. Results A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, which was at the 90th percentiles for detecting at least two of the above three CV risk factors. In comparison with children with waist circumference below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between the 75th and the 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing with waist circumference remained significant after having been stratified by BMI category. Conclusion The 75th and the 90th percentiles of WC are the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents, respectively.

Effectiveness of Different Waist Circumference Cut-off Values in Predicting Metabolic Syndrome Prevalence and Risk Factors in Adults in China

Objective To study the effectiveness of waist circumference cut-off values in predicting the prevalence of metabolic syndrome （MetS） and risk factors in adults in China. Methods A cross-sectional survey was condcuted in 14 provinces （autonomous region, municipality） in China. A total of 47 325 adults aged 〉20 years were selected by multistage stratified sampling, and questionnaire survey and physical and clinical examination were conducted among them. MetS was defined according to the International Diabetes Federation （IDF） criteria and modified IDF criteria.Results The age-standardized prevalence of MetS was 24.2% （22.1% in men and 25.8% in women） and 19.5% （22.1% in men and 18.0% in women} according to the IDF criteria and modified IDF criteria respectively. The age-standardized prevalence of pre-MetS was 8.1% （8.6% in men and 7.8% in women） according to the modified IDF criteria. The prevalence of MetS was higher in urban residents than rural residents and in northern China residents than in southern China residents. The prevalence of central obesity was about 30% in both men and women according to the ethnicity-specific cut-off values of waist circumference for central obesity （90 cm for men and 85 cm for women）. Multivariate regression analysis revealed no significant difference in risk factors between the two MetS definitions. Conclusion Using both the modified IDF criteria and ethnicity-specific cut-off values of waist circumference can provide more useful information about the prevalence of MetS in China.

Fatty liver index vs waist circumference for predicting non-alcoholic fatty liver disease

AIM: To determine the discriminatory performance of fatty liver index (FLI) for non-alcoholic fatty liver disease (NAFLD).METHODS: The data of 5052 subjects aged over 18 years were analyzed. FLI was calculated from body mass index, waist circumference (WC), triglyceride, and gamma glutamyl transferase data. Logistic regression analysis was conducted to determine the association between FLI and NAFLD. The discriminatory performance of FLI in the diagnosis of NAFLD was evaluated by receiver operating characteristic analysis. Area under the curves (AUCs) and related confidence intervals were estimated. Optimal cutoff points of FLI in the diagnosis of NAFLD were determined based on the maximum values of Youden&#x02019;s index.RESULTS: The mean age of men and women in the study population were 44.8 &#x000b1; 16.8 and 43.78 &#x000b1; 15.43, respectively (P = 0.0216). The prevalence of NAFLD was 40.1% in men and 44.2% in women (P &#x0003c; 0.0017). FLI was strongly associated with NAFLD, so that even a one unit increase in FLI increased the chance of developing NAFLD by 5.8% (OR = 1.058, 95%CI: 1.054-1.063, P &#x0003c; 0.0001). Although FLI showed good performance in the diagnosis of NAFLD (AUC = 0.8656 (95%CI: 0.8548-0.8764), there was no significant difference with regards to WC (AUC = 0.8533, 95%CI: 0.8419-0.8646). The performance of FLI was not significantly different between men (AUC = 0.8648, 95%CI: 0.8505-0.8791) and women (AUC = 0.8682, 95%CI: 0.8513-0.8851). The highest performance with regards to age was related to the 18-39 age group (AUC = 0.8930, 95%CI: 0.8766-0.9093). The optimal cutoff points of FLI were 46.9 in men (sensitivity = 0.8242, specificity = 0.7687, Youden&#x02019;s index = 0.5929) and 53.8 in women (sensitivity = 0.8233, specificity = 0.7655, Youden&#x02019;s index = 0.5888).CONCLUSION: Although FLI had acceptable discriminatory power in the diagnosis of NAFLD, WC was a simpler and more accessible index with a similar performance.

Visceral Fat Area,Waist Circumference and Metabolic Risk Factors in Abdominally Obese Chinese Adults

Objective To examine the association of visceral adiposity as measured by VFA and WC with lipid and glucose metabolic biomarkers in abdominally obese Chinese adults,and to assess whether WC could be an indicator of visceral fat.Methods WC and VFA were measured in 155 overweight and obese adults.A fasting blood sample was collected from participant（n=118） whose VFA ≥100 cm2 for analyses of lipid and glucose profile.The relationship between VFA and WC and biomarkers was investigated.Results WC and VFA were significantly interrelated.The coincidence rate of abdominal obesity determined by Japanese VFA and Chinese WC criteria increased across age quartiles in women from 51.7% to 96.2%.A large WC was associated significantly with low HDL-cholesterol concentration（P0.01） and the association was weakened by additional control of VFA.WC and VFA were positively associated with glucose,hemoglobin A1c and insulin concentrations（P0.05 except for the association of VFA with insulin：P0.01）,and all the associations were not significant by additional control of either WC or VFA.As WC quartiles increased,significant stepwise increments in triglyceride,glucose,hemoglobin A1c and insulin and descent in HDL-cholesterol were observed.However,triglyceride and HDL-cholesterol were not significantly different when compared across VFA quartiles.Conclusion Higher visceral fat was associated with an adverse lipid and glucose profile.WC can be a moderate predictor for visceral fat and provides a feasible measurement to estimate glucose metabolic risks.Further studies are warranted to establish age-specific WC cutoffs.

Are body mass index and waist circumference significant predictors of diabetes and prediabetes risk: Results from a population based cohort study

AIM To determine the predictive role of body mass index(BMI) and waist circumference(WC) for diabetes and prediabetes risk in future in total sample as well as in men and women separately. METHODS In a population based cohort study, 1765 with mean ± SD age: 42.32 ± 6.18 healthy participants were followed up from 2003 till 2013(n = 960). Anthropometric and biochemical measures of participants were evaluated regularly during the follow up period. BMI and WC measures at baseline and diabetes and prediabetes status of participants at 2013 were determined. Multivariable logistic regression analysis was used for determining the risk of diabetes and prediabetes considering important potential confounding variables. Receiver operatingcharacteristic curve analysis was conducted to determine the best cut of values of BMI and WC for diabetes and prediabetes. RESULTS At 2013, among participants who had complete data, 45 and 307 people were diabetic and prediabetic, respectively. In final fully adjusted model, BMI value was a significant predictor of diabetes(RR = 1.39, 95%CI: 1.06-1.82 and AUC = 0.68, 95%CI: 0.59-0.75; P < 0.001) however not a significant risk factor for prediabetes. Also, WC was a significant predictor for diabetes(RR = 1.2, 95%CI: 1.05-1.38 and AUC = 0.67, 95%CI: 0.6-0.75) but not significant risk factor for prediabetes. Similar results were observed in both genders.CONCLUSION General and abdominal obesity are significant risk factors for diabetes in future.

Correlation between Waist Circumference and Carotid Intima-Media Thickness in Women from Shanghai, China

Objective To evaluate whether waist circumference （WC） 〉85 cm is related to asymptomatic preclinical atherosclerosis in women from Shanghai, China. Methods A total of 2365 females aged 〉20 years recruited from 4 communities underwent physical examination and carotid artery scanning. Their carotid intima-media thickness （C-iMT） was measured. Results The C-IMT was significantly higher in overweight or obese women with their BMI 〉25.0 kg/m2 {P〈O.01） and in those with their WC _〉85 cm than in those with their WC 〈85 cm （P〈O.01）. Spearman and partial correlation analysis showed that the C-IMT was significantly correlated with WC which was independent of menopausal status. The C-IMT significantly increased with the increasing WC and reached to a platform in about 85 cm. An increment tendency was found in the subgroup with its WC 〈 85 cm （P〈O.01） while no significant tendency was found in the subgroup with its WC_〉85 cm （P=0.07）. Multiple stepwise regression analysis showed that the WC was an independent risk factor for C-IMT. In logistic regression model, the odd ratio of WC _〉80 cm, _〉80 cm and 〈85 cm and 〉85 cm for evaluating the risk of C-IMT elevation was 2.632, 2.501, and 1.878, respectively. Conclusion WC is significantly correlated with C-IMT in women from Shanghai, China, and WC_〉85 cm may be used in identifying the risk of subclinical carotid atherosclerosis.

Changes in Waist Circumference and Abdominal Obesity among Chinese Adults over a Ten-year Period

Objective The aim of this study was to describe changes in waist circumference（WC） and prevalence of abdominal obesity over a period of 10 years among Chinese adults in different socio-economic status（SES）. Methods Data derived from the China Nutrition and Health Surveillance during 2002 and 2010-2012. We calculated the mean WC and the prevalence of abdominal obesity by gender, place of residence, SES indicators（education, income, and marital status）, and body mass index（BMI） categoriesand used pooled t-tests to assess the differences between the two time periods. Results 26.0% of men and 25.3% of women had abdominal obesity in 2010-2012. The age-adjusted mean WC increased by 2.7 cm among men and 2.1 cm among women; the age-adjusted prevalence of abdominal obesity increased by 7.7% among men and 5.3% among women. The rising trends were observed in all subgroups except for a negative growth in high-income women. People living in rural areas with low education and income and with a BMI of 18.5 to 23.9 kg/m^2 had a greater absolute and relative increase in WC. People living in rural areas with low income had a greater relative increase in abdominal obesity. Conclusion The mean WC and prevalence of abdominal obesity among Chinese adults have increased during the past 10 years. Gender differences were noted using various SES indicators.

Optimal Waist Circumference Cut-off values for Identifying Metabolic Risk Factors in Middle-aged and Elderly Subjects in Shandong Province of China

Objective To study the optimal waist circumference （WC） cut-off values for identifying metabolic risk factors in middle-aged and elderly subjects in Shandong Province of China. Methods A total of 2 873 men and 5 559 women were included in this cross-sectional study. Metabolic syndrome （MetS） was diagnosed according to the definition of Chinese Diabetes Society in 2004. The relation between WC and MetS was analyzed by multivariate logistic regression analysis. The optimal WC cut-off values were identified using the area under the ROC curve and the different diagnostic criteria for central obesity were compared. Results The WC was the risk factor for MetS independent of BMI, blood glucose, blood lipid, and blood pressure. The optimal WC cut-off value was 83.8 cm and 91.1 cm for identifying MetS in women and men, respectively. Compared with 80 cm and 85 cm for women and men, 85 cm and 90 cm had a higher Youden index for identifying all metabolic risk factors and MetS in women and men. Conclusion The appropriate WC cut-off value is 85 cm and 90 cm for identifying central obesity and MetS in women and men in Shandong Province of China.

Waist Circumference of the Elderly over 65 Years Old in China Increased Gradually from 1993 to 2015: A Cohort Study

Objective This study aimed to analyze the temporal trends and characteristics associated with waist circumference(WC)among elderly Chinese people.Methods We used data from 3,096 adults≥65 years who participated in the China Health and Nutrition Survey(CHNS),an ongoing cohort study,between 1993 and 2015.We used longitudinal quantile regression models to explore the temporal trends and characteristics associated with WC.Results WC increased gradually among the elderly Chinese population during the survey.The WC curves shifted to the right with wider distributions and lower peaks in men and women.All WC percentile curves shifted upward with similar growth rates in the 25th,50th,and 75th percentiles.The WC means increased from 78 cm to 86 cm during the 22 years of our study.WC significantly increased with age and body mass index and decreased with physical activity(PA).These associations were stronger in the higher percentiles than in the lower percentiles.Conclusions WC is rising among Chinese adults≥65 years.Factors affecting WC in elderly people may have different effects on different percentiles of the WC distribution,and PA was the most important protective factor in the higher percentiles of the WC distribution.Thus,different interventional strategies are needed.

Relationship between Waist Circumference and Elevation of Carotid Intima-media Thickness in Newly-diagnosed Diabetic Patients

Objective Waist circumference, as a brief indicator of visceral obesity, is associated with multi-metabolic disorders and cardiovascular diseases. The present study was aimed to find out the relationship between waist circumference and carotid intima media thickness （C-IMT）, as well as the best waist circumference cutoff for identifying C-IMT elevation in Chinese male patients with newly-diagnosed diabetes. Methods Five hundred and seventy-eight patients from Department of Endocrinology and Metabolism in Shanghai Sixth People＇s Hospital affiliated to Shanghai Jiao Tong University were enrolled. Both physical examination （for measurement of waist circumference） and carotid ultrasonography （for measurement of C-IMT） were performed. Results After grouping according to the quartiles of C-IMT, the waist circumference increased across all its quartiles. The waist circumference in 3rd and 4th quartiles （90.7_＋9.8 cm and 90.8＋9.6 cm） was significant higher than in 1st and 2nd quartiles （P〈0.05）. When subjects were divided into 4 groups according to waist circumference, the C-IMT of subjects with waist circumference 90-95 cm was significant higher than that of subjects with waist circumference 85-90 cm and less than 85 cm respectively （P〈0.05）. Both spearman and partial correlation analysis showed that C-IMT was positively correlated with waist circumference （P〈0.01）. C-IMT was found significantly elevated with the increase of waist circumference. Multiple stepwise regression analysis showed that waist circumference was one of the independent risk factors of C-IMT. After an average of 2.23_＋0.85 years follow up, there was a significant elevation of C-IMT in the group with baseline waist circumference over 90 cm P〈0.05）, while no significant difference was detected in the group with baseline waist circumference less than 90 cm （P=0.27）. Logistic regression showed that baseline waist circumference over 90 cm was associated with a relative risk to C-IMT elevation of 1.132 （95% CI 1.043-1.431, P〈0.05）. Conclusion Among newly-diagnosed diabetic male patients, waist circumference over 90 cm not only reflects sub-clinical atherosclerosis in early stage, but also predicts the progression of atherosclerosis.

Earlier Menarche Can Be an Indicator of More Body Fat:Study of Sexual Development and Waist Circumference in Chinese Girls

Objective This paper aims to study the relationship between body fat and sexual development in Chinese girls with different waist circumference.Methods Six thousand one hundred and fifty six girls aged 6-19 were sampled.Their body weight,height,waist circumference,percentage of body fat and secondary sex characteristics were measured.All the subjects were divided into three groups：low class waist circumference,moderate class waist circumference and high class waist circumference.The menarche percentages were analyzed by using the status method.The menarche ages were analyzed by using the retrospective method.Estimates for mean age at entry into a pubertal stage and menarche were calculated by a probit analysis.Results The incidences of moderate class and high class waist circumstance were 20.94% and 25.27%,respectively.The sexual development of the former was earlier than that of the latter.The percentages of the menarche were detected as high classmoderate classlow class.The menarche ages were expressed as high classmoderate classlow class.Conclusion A close association is found between the waist circumference and sexual development,especially the menarche age.Girls with high class waist circumference are more vulnerable to earlier menarche and excess body fat.It is important to control the occurrence of central obesity through monitoring the change of waist circumference in puberty for girls＇ health.

Waist circumference cutoff points for Chinese adults with metabolic syndrome defined by the International Diabetes Federation

Objective To investigate the appropriate waist circumference(WC)cutoff points for central obesity in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of the International Diabetes Federation(IDF).Methods A total of 2,344 Beijing residents aged≥40 years were investigated.They answered questionnaires,received physical examinations,and underwent plasma glucose and lipid profile measurement.Those non-diabetic subjects underwent a 75g oral glucose tolerance test.All data were analyzed to calculate the appropriate WC cutoff points for central obesity reaching the diagonsis of MS.Results 1)Both in males and females,the triglyceride(TG),systolic blood pressure,diastolic blood pressure and fasting plasma glucose(FPG)increased linearly with WC,and the high density lipoprotein cholesterol(HDL-C)decreased linearly with WC(P<0.05).2)The prevalence of elevated TG,reduced HDL-C,elevated blood pressure,elevated FBG,or≥2 of these factors increased with WC(P<0.05).3)Based on the receiver operating characteristic(ROC)curve analysis and Youden index,the WC values for central obesity and for detecting BMI≥25 kg/m^(2) were about 90 cm for men and 80 cm for women.4)The odds ratio for the presence of two or more metabolic risk factors increased abruptly in men with WC≥90 cm and in women with WC≥80 cm.Conclusions The appropriate WC cutoff point for central obesity was determined to be 90 cm for men and 80 cm for women in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of IDF.

Genetically predicted waist circumference and risk of atrial fibrillation

Introduction:Observational studies have revealed an association between waist circumference(WC)and atrial fibrillation(AF).However,it is difficult to infer a causal relationship from observational studies because the observed associations could be confounded by unknown risk factors.Therefore,the causal role of WC in AF is unclear.This study was designed to investigate the causal association between WC and AF using a two-sample Mendelian randomization(MR)analysis.Methods:In our two-sample MR analysis,the genetic variation used as an instrumental variable for MR was acquired from a genome-wide association study(GWAS)of WC(42 single nucleotide polymorphisms with a genetic significance of P<5×10^(-8)).The data of WC(from the Genetic Investigation of ANthropometric Traits consortium,containing 232,101 participants)and the data of AF(from the European Bioinformatics Institute database,containing 55,114 AF cases and 482,295 controls)were used to assess the causal role of WC on AF.Three different approaches(inverse variance weighted[IVW],MR-Egger,and weighted median regression)were used to ensure that our results more reliable.Results:All three MR analyses provided evidence of a positive causal association between high WC and AF.High WC was suggested to increase the risk of AF based on the IVW method(odds ratio[OR]=1.43,95%confidence interval[CI],1.30-1.58,P=2.51×10^(-13)).The results of MR-Egger and weighted median regression exhibited similar trends(MR-Egger OR=1.40[95%CI,1.08-1.81],P=1.61×10^(-2);weighted median OR=1.39[95%CI,1.21-1.61],P=1.62×10^(-6)).MR-Egger intercepts and funnel plots showed no directional pleiotropic effects between high WC and AF.Conclusions:Our findings suggest that greater WC is associated with an increased risk of AF.Taking measures to reduce WC may help prevent the occurrence of AF.

Associations of waist circumference with sex steroid hormones among 4031 USA children and adolescents

In the recent decades,obesity rates among children and adolescents,especially males,have increased significantly.This worldwide phenomenon is thought to significantly affect the levels of sex hormones.However,the association between waist circumference(a marker of abdominal obesity)and sex hormone levels in children and adolescents is unknown.In this study,4031 participants aged 6–19 years from the United States National Health and Nutrition Examination Survey(NHANES)in the USA were enrolled in this study.The common confounders of age,race,body mass index,educational level,family income,diabetes,and time of sample collection were also collected.The participants missing any of the above information were excluded from the study.We used multiple linear regression and other multiple statistics to assess the associations between waist circumference and serum testosterone,estradiol,sex hormone-binding globulin(SHBG),free androgen index(FAI),and testosterone/estradiol ratio(T/E2).Waist circumference remained associated with sex hormone levels in children and adolescents after controlling for covariates.As waist circumference increases,testosterone levels in children and adolescents show an overall decline after a brief increase,with the inflection point for waist circumference of 65–66 cm.In addition,waist circumference positively correlates with estradiol levels in male children(β=0.007,95%confidence interval:0.004–0.009).Moreover,circulating SHBG decreases in children and adolescents as waist circumference increases.In conclusion,this study highlighted waist circumference as a vital indicator affecting sex hormone levels in children and adolescents.

Body mass index,waist circumference,and cardiometabolic risk factors in young and middle-aged Chinese women

Objective: To assess the associations between body mass index (BMI), waist circumference (WC), and cardiometabolic risk factors in young and middle-aged Chinese women. Methods: A total of 3011 women (1938 young women, 1073 middle-aged women), who visited our health care center for a related health checkup, were eligible for study. BMI and WC were measured. The subjects were divided into normal and overweight/obesity groups based on BMI, and normal and abdominal obesity groups based on WC. Cardiometabolic variables included triglyceride (TG), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), and blood pressure (BP). Results: The prevalence of overweight/obesity was significantly higher in middle-aged women (32.4%) than in young women (12.0%). The prevalence of abdominal obesity was also higher in middle-aged women (60.3%) than in young women (36.2%). There were significant differences in the comparison of all related cardiometabolic variables between different BMI (or WC) categories in young and middle- aged women groups, respectively. After adjustment for age, partial correlation analysis indicated that both BMI and WC were correlated significantly with all related cardiometabolic variables. After adjustment for age and WC, although the correlation coefficient r′was attenuated, BMI was still correlated significantly with all related cardiometabolic variables in young and middle-aged women. After adjustment for age and BMI, partial correlation analysis showed that WC was correlated significantly with TG, FBG, HOMA-IR, and HDL-C in young women and significantly with TG, HOMA-IR, and HDL-C in middle-aged women. Conclusions: The prevalence of overweight/obesity and abdominal obesity was high in Chinese young and middle-aged women. BMI was a better predictor of cardiovascular disease and diabetes than WC in young and middle-aged women, and moreover, measurement of both WC and BMI may be a better predictor of cardiovascular disease and diabetes mellitus than BMI or WC alone.

Investigating the causal associations between five anthropometric indicators and nonalcoholic fatty liver disease:Mendelian randomization study

BACKGROUND Although the etiology of nonalcoholic fatty liver disease(NAFLD)has not been thoroughly understood,the emerging roles of anthropometric indicators in assessing and predicting the risk of NAFLD have been highlighted by accumulating evidence.AIM To evaluate the causal relationships between five anthropometric indicators and NAFLD employing Mendelian randomization(MR)design.METHODS The Anthropometric Consortium provided genetic exposure data for five anthropometric indicators,including hip circumference(HC),waist circumference(WC),waist-to-hip ratio(WHR),body mass index(BMI),and body fat percentage(BF).Genetic outcome data for NAFLD were obtained from the United Kingdom Biobank and FinnGen Consortium.Genome-wide significant single nucleotide polymorphisms were chosen as instrumental variables.Univariable MR(UVMR)and multivariable MR(MVMR)designs with analytical approaches,including inverse variance weighted(IVW),MR-Egger,weighted median(WM),and weighted mode methods,were used to assess the causal relationships between anthropometric indicators and NAFLD.RESULTS Causal relationships were revealed by UVMR,indicating that a higher risk of NAFLD was associated with a perunit increase in WC[IVW:odds ratio(OR)=2.67,95%CI:1.42-5.02,P=2.25×10^(−3)],and BF was causally associated with an increased risk of NAFLD(WM:OR=2.23,95%CI:1.07-4.66,P=0.033).The presence of causal effects of WC on the decreased risk of NAFLD was supported by MVMR after adjusting for BMI and smoking.However,no causal association between BF and NAFLD was observed.In addition,other causal relationships of HC,WHR(BMI adjusted),and BMI with the risk of NAFLD were not retained after FDR correction.CONCLUSION This study establishes a causal relationship,indicating that an increase in WC is associated with a higher risk of NAFLD.This demonstrates that a suitable decrease in WC is advantageous for preventing NAFLD.

Correlation between non-alcoholic fatty liver disease and metabolic parameters in persons with newly diagnosed type 2 diabetes mellitus

BACKGROUND There are limited studies investigating the association between type 2 diabetes mellitus(T2DM)and non-alcoholic fatty liver disease(NAFLD)in the region of Bihar,India.AIM To estimate the prevalence of NAFLD in persons with newly diagnosed T2DM in the population of North Bihar,India.METHODS This single centre cross-sectional study was undertaken in the Research Centre for Diabetes Hypertension and Obesity,Samastipur,Bihar,India.Data were collected from persons newly diagnosed with T2DM or those diagnosed within 6 months of when the study was conducted between December 2022 to May 2023.RESULTS A total of 148 people with newly diagnosed T2DM were included(median age 47 years,46.6%female)and 109 patients with liver disease on ultrasound evaluation.The persons with liver disease consumed more fats and oils(88.1%vs 74.4%,P=0.042)and they had significantly greater body mass index(27.4 vs 23.0,P<0.001),waist circumference(37 vs 33,P<0.001),and waist-to-hip ratio(1.00 vs 0.70,P=0.025).Females were associated with greater liver disease[odds ratio(OR):3.09,95%confidence interval(CI):1.09-8.80,P=0.32].Waist circumference(OR:1.42,95%CI:1.22-1.66,P<0.001)and low-density lipoprotein cholesterol(OR:1.01,95%CI:1.01-1.02,P=0.048)were associated with any liver disease.The factors most associated with grade 2/3 liver disease was right upper quadrant pain or heaviness(OR:5.22,95%CI:1.40-19.41,P=0.14),greater income(OR:3.58,95%CI:1.28-10.04,P=0.015)and waist circumference(OR:1.31,95%CI:1.02-1.69,P=0.036).CONCLUSION NAFLD is common in new/recently diagnosed T2DM and disease burden is high and common among patients who are either high consumers of fats and oils or have obesity-associated markers.