Analysis of the Correlation Between Visceral Fat Area and Insulin Resistance in Patients with Type 2 Diabetes and Abdominal Obesity

Objective: To analyze the correlation between visceral fat area and insulin resistance index (HOMA-IR) in patients with type 2 diabetes mellitus (T2DM) and abdominal obesity and to provide a reference for screening and related research of such patients. Methods: Two hundred patients with T2DM admitted to Guandu People’s Hospital of Kunming were included. The study was carried out from October 2022 to December 2023. The patients were divided into three groups according to different abdominal visceral fat areas (VFA): Group A (n = 65) was less than 75cm2, Group B (n = 75) was 75-100 cm2, and Group C (n = 60) was greater than 100 cm2. The subjects in the three groups were all tested for glycated hemoglobin (HbA1c), fasting insulin (FINS), and fasting blood glucose (FPG). Height and weight were measured to calculate body mass index (BMI). The HOMA-IR and TYG (fasting triglyceride and glycemic index) were also calculated. Changes in the BMI, VFA, HOMA-IR, and TYG levels were observed in the three groups. Results: The VFA, BMI, HbA1c, FPG, FINS, HOMA-IR, and TYG of the patients all increased, with a more significant increase in the BMI, FINS, HOMA-IR, and TYG levels (P < 0.01). Multiple linear stepwise regression analyses used visceral fat area (VFA) as the dependent variable. The results showed that VFA was closely related to BMI, FINS, HOMA-IR, and TYG. Conclusion: Early reduction of VFA to reduce insulin resistance may be a better treatment and effective method for T2DM, providing powerful measures and new strategies for effective blood sugar control and early prevention in the treatment of metabolic diseases.

Correlation between type 2 diabetes mellitus remission and intrapancreatic fat deposition

BACKGROUND Intrapancreatic fat deposition(IPFD)exerts a significant negative impact on patients with type 2 diabetes mellitus(T2DM),accelerates disease deterioration,and may lead to impairedβ-cell quality and function.AIM To investigate the correlation between T2DM remission and IPFD.METHODS We enrolled 80 abdominally obese patients with T2DM admitted to our institution from January 2019 to October 2023,including 40 patients with weight lossinduced T2DM remission(research group)and 40 patients with short-term intensive insulin therapy-induced T2DM remission(control group).We comparatively analyzed improvements in IPFD[differential computed tomography(CT)values of the spleen and pancreas and average CT value of the pancreas];levels of fasting blood glucose(FBG),2-h postprandial blood glucose(2hPBG),and insulin;and homeostasis model assessment of insulin resistance(HOMA-IR)scores.Correlation analysis was performed to explore the association between T2DM remission and IPFD.RESULTS After treatment,the differential CT values of the spleen and pancreas,FBG,2hPBG,and HOMA-IR in the research group were significantly lower than those before treatment and in the control group,and the average CT value of the pancreas and insulin levels were significantly higher.Correlation analysis revealed that the greater the T2DM remission,the lower the amount of IPFD.

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.

A pilot study of radiologic measures of abdominal adiposity:weighty contributors to early pancreatic carcinogenesis worth evaluating?

Objective:Intra-abdominal fat is a risk factor for pancreatic cancer(PC),but little is known about its contribution to PC precursors known as intraductal papillary mucinous neoplasms(IPMNs).Our goal was to evaluate quantitative radiologic measures of abdominal/visceral obesity as possible diagnostic markers of IPMN severity/pathology.Methods:In a cohort of 34 surgically-resected,pathologically-confirmed IPMNs(17 benign;17 malignant) with preoperative abdominal computed tomography(CT) images,we calculated body mass index(BMI) and four radiologic measures of obesity:total abdominal fat(TAF) area,visceral fat area(VFA),subcutaneous fat area(SFA),and visceral to subcutaneous fat ratio(V/S).Measures were compared between groups using Wilcoxon two-sample exact tests and other metrics.Results:Mean BMI for individuals with malignant IPMNs(28.9 kg/m^2) was higher than mean BMI for those with benign IPMNs(25.8 kg/m^2)(P=0.045).Mean VFA was higher for patients with malignant IPMNs(199.3 cm^2) compared to benign IPMNs(120.4cm^2),P=0.092.V/S was significantly higher(P=0.013) for patients with malignant versus benign IPMNs(1.25 vs.0.69 cm^2),especially among females.The accuracy,sensitivity,specificity,and positive and negative predictive value of V/S in predicting malignant IPMN pathology were 74%,71%,76%,75%,and 72%,respectively.Conclusions:Preliminary findings suggest measures of visceral fat from routine medical images may help predict IPMN pathology,acting as potential noninvasive diagnostic adjuncts for management and targets for intervention that may be more biologically-relevant than BMI.Further investigation of gender-specific associations in larger,prospective IPMN cohorts is warranted to validate and expand upon these observations.

Decreased Gastric Body Mucosa Obestatin Expression in Abdominal Obesity Patients With Normal Body Mass Index

The aim of the study was to investigate whether the expression of obestatin in gastric body mucosa in abdominal obesity patients with normal body mass index （BMI） is different compared with healthy controls. Twenty abdominal obesity patients with normal BMI and twenty healthy controls were included in the study. The number of obestatin-positive cells in gastric body mucosa was significantly lower in abdominal obesity patients with normal BMI than that in healthy subjects.

Effects of Endurance and Endurance-strength Exercise on Renal Function in Abdominally Obese Women with Renal Hyperfiltration：A Prospective Randomized Trial

Objective Obesity is associated with kidney defects.Physical activity is a key element in the treatment of obesity.The aim of this study was to compare the effect of endurance and endurance-strength training on kidney function in abdominally obese women.Methods Forty-four abdominally obese women were randomized to endurance training or endurance-strength training,three times a week for 3 months.Before and after the intervention,kidney function was assessed by measuring blood creatinine,urine creatinine,and urine albumin levels,and the albumin-to-creatinine ratio and glomerular filtration rate（GFR） were calculated.Results Renal hyperperfusion was present in both groups before the study.Following both types of physical activity,similar modifications of the investigated parameters were observed,but with no significant between-group differences.Both courses of training led to a significant increase in blood creatinine and a subsequent decrease in the GFR.A significant increase in urine creatinine and album levels,though not exceeding the range for microalbuminuria,was not accompanied by any difference in the albumin-to-creatinine ratio after endurance-strength training alone.Conclusion Three months of either endurance or endurance-strength training has a favorable and comparable effect on renal function in abdominally obese women with renal hyperfiltration.

Study on intestinal flora of acupoint catgut embedding intervention in female patients with abdominal obesity: study protocol for a randomized controlled trial

Background:Obesity,as an epidemic public health issue in the world today,not only brings a heavy medical burden to society but also seriously affects people’s quality of life.In the context of new evidence for the efficacy of acupoint catgut embedding(ACE)in abdominal obesity(AO),it is necessary to elucidate the mechanism of ACE for AO.The intestinal flora is closely associated with obesity,and the study of its intestinal flora may provide evidence to clarify the mechanism of obesity treatment by ACE.Methods:75 participants will be recruited in this study,including 60 eligible female patients diagnosed with AO and 15 healthy female participants.60 female AO patients will be randomized to ACE group,sham ACE group,and waiting list(WL)group in a ratio of 1:1:1.Patients in two ACE groups will receive one ACE treatment per week for 12 consecutive weeks,and in the WL group will not receive any treatment;only their data will be extracted.The primary outcome is the mean change in body mass index.Secondary effects include waist circumference,body weight,the visual analog score of appetite,and the Gastrointestinal Symptom Rating Scale.High-throughput 16S ribosomal ribonucleic acid gene sequencing will be used to detect intestinal flora in each group before and after the intervention.Conclusion:The results of this trial are expected to identify the critical intestinal flora causing AO and the target intestinal flora of AO regulated by ACE,providing further theoretical support for ACE in the clinical treatment of obesity.

Prevalence and Predictors of Obesity among Undergraduate Students at a Private University, Nairobi, Kenya

Background: Obesity, especially central obesity, is a major risk factor for cardiovascular diseases and type-2 diabetes, known for their significant morbidity and mortality. University students are at increased risk of obesity due to adoption of unhealthy lifestyles and school-related stress. However, there is scant information regarding the prevalence and risk factors of obesity among university students in Kenya. The study aimed to determine the prevalence and factors associated with general and abdominal obesity among undergraduate students of The Catholic University of Eastern Africa, Kenya. Methods: A cross-sectional study design was employed among undergraduate students (n = 245) of The Catholic University of Eastern Africa, Nairobi. A systematic random sampling method was used to select the study participants. Lifestyle risk factors associated with obesity were collected using a structured questionnaire adopted from the WHO STEP-wise approach to non-communicable disease risk factor surveillance. Anthropometric measures of weight, height, and waist circumference were appropriately measured. The data were analyzed using SPSS software (ver: 22). The chi-square test of independence and binary logistic regression was used to establish an association between dependent and independent variables. Results: The prevalence of general and abdominal obesity was 19.6% and 27.8%, respectively. Risk factors of general obesity were age ≥ 20 years (OR, 9.95;95% CI, 3.09 - 32.08, p < 0.001), sedentary lifestyle (OR, 11.36;95% CI, 2.08 - 61.96, p = 0.005), staying with parents (OR, 3.22;95% CI, 1.09 - 9.58, p = 0.035), consumption of fast/processed foods (OR, 7.83;95% CI, 1.90 - 32.21, p = 0.004). Risk factors for abdominal obesity were being female (OR, 38.76;95% CI, 5.07 - 296.54, p < 0.001), staying with parents (OR, 3.02;95% CI, 1.14 - 7.99, p = 0.026) and sedentary lifestyle (OR, 6.55;95% CI, 1.80 - 23.81, p = 0.004). Conclusion: Being female, sedentary lifestyle, and consumption of fast/processed foods were found as predictors of obesity. Behavioural intervention is required to mitigate the burden of obesity among university students in Kenya. This can be achieved through promoting intervention programmes that lead to changing the built environment, counseling, and behavioral-lifestyle modification of students.

The Association of Mercury and ALT with Obesity in Korean Adults Using Data from the Korea National Health and Nutrition Examination Survey for 11 Years(KNHANES 2005,2008-2017)

The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data from 119,181 participants of the Korea National Health and Nutrition Examination Survey(KNHANES)for 11 years in 2005 and between 2008 and 2017.The subjects with missing heavy metal blood tests,health interview data,and health examination data were excluded from the study.The study population comprised 1,844 individuals(972 men,and 872 women)who were eligible for inclusion.It was found that obesity and abdominal obesity were associated with an increase in both blood mercury(P<0.001)and alanine aminotransferase(ALT)(P<0.001).After adjusting the confounding factors,those with concurrent high levels of ALT and the highest tertile of mercury showed an increased risk of obesity(odds ratio 4.46,95%confidence interval 2.23-8.90,P<0.001)as well as abdominal obesity(odds ratio 5.36,95%confidence interval 2.57-11.17,P<0.001).The interrelationship of mercury and ALT with the parameters of body mass index(P for interaction=0.009)and waist circumference(P for interaction=0.012),respectively,have been observed to be significant,suggesting that the reciprocal relationship could contribute to obesity and abdominal obesity.

Clustering of Cardiovascular Risk Factors and Diabetes： A Prospective Cohort Study on the Inner Mongolian Population in China

Objective To evaluate the effect of clustering of cardiovascular risk factors（CVRFs） on type 2 diabetes mellitus（T2 DM） incidence and identify some high predictive clusters in the Inner Mongolian population in China. Methods A total of 1,884 Mongolian individuals aged 20 years or above were followed up from 2002 to 2013 and included in the final analysis. We categorized the participants into two subgroups according to the study outcome event. A Cox proportional hazards model was used to evaluate the effect of clustering of CVRFs on the incidence of T2 DM. Areas under the curve were used to compare the effect of every cluster on T2 DM and identify those having higher predictive value. Results We found 203 persons with T2 DM. Subjects with incident T2 DM tended to be older, had a higher prevalence of drinking, had higher systolic and diastolic pressures; total cholesterol, triglyceride, low-density lipoprotein cholesterol, and C-reactive protein levels; waist circumference; body mass index; and heart rate and lower HDL-C level than did those without T2 DM. The multivariable adjusted hazard ratio（95% confidence interval） of T2 DM was calculated based on comparisons with subjects with 0 CVRFs; in participants with 2 and ≥ 3 factors, the adjusted hazard ratios were 2.257（1.448, 3.518） and 3.316（2.119, 5.188）, respectively. Conclusion The clustering of CVRFs increased the risk of T2 DM. On the basis of fast heart rate, the cluster of abdominal obesity and other CVRFs had higher predictive value for T2 DM than the other three CVRF clusters.

Effect of exercise training intensity on adipose tissue hormone sensitive lipase gene expression in obese women under weight loss

Background:Hormone sensitive lipase(HSL) is an enzyme that regulates adipose tissue lipolysis and plays an important role in chronic exerciseinduced changes in adipose tissue metabolism.The purpose of this study was to determine whether aerobic exercise intensity influences abdominal adipose tissue HSL gene expression in obese women under weight loss. Methods:Thirty women(body mass index(BMI) = 33.0±0.7 kg/m^2,age = 58±1 years) completed one of three 20-week interventions: caloric restriction alone(CR only,n = 8),CR plus moderate-intensity exercise(CR + moderate-intensity,45%—50%heart rate reserve(HRR). 3 day/week,n = 9),or CR plus vigorous-intensity exercise(CR + vigorous-intensity,70%—75%HRR,3 day/week,n = 13).Each group had a similar prescribed energy deficit comprised of underfeeding alone(2800 kcal/week for CR only) or underfeeding(2400 kcal/week) plus exercise(400 kcal/week).Body composition and maximal aerobic capacity(VO_2max) were measured,and subcutaneous abdominal adipose tissue samples were collected before and after the interventions.Adipose tissue HSL gene expression was measured by real time reversetranscriptase polymerase chain reaction. Results:All three interventions reduced body weight,fat mass,percent fat.and waist to a similar degree(all p < 0.01).In addition,all interventions did not change absolute VO_2 max,but increased relative VO_2 max(p < 0.05 to P < 0.01).Compared to pre-intervention.neither CR only nor CR + moderate-intensity changed adipose tissue HSL gene expression,but CR + vigorous-intensity significantly increased adipose tissue HSL gene expression(p < 0.01).The changes of HSL gene expression levels in the CR + vigorous-intensity group were significantly different from those in the CR only(p < 0.05) and CR + moderate-intensity(p < 0.01) groups.In the whole cohort,changes in adipose tissue HSL gene expression correlated positively to changes in absolute(r = 0.55,p < 0.01) and relative(r = 0.32,p = 0.09) VO_2 max. Conclusion:These results support a potential effect of aerobic exercise training intensity on hormone sensitive lipase pathway in adipose tissue metabolism in obese women under weight loss.

Factors associated with improvement in waist-to-height ratio among newly diagnosed type 2 diabetes patients treated with acarbose or metformin:A randomized clinical trial study

BACKGROUND The waist-to-height ratio(WHtR)is a promising anthropometric measure used to evaluate cardiovascular risk in diabetes and metabolic syndrome patients.The metformin and acarbose in Chinese as the initial hypoglycaemic treatment trial demonstrated that acarbose and metformin reduced the WHtR after 24 wk of treatment.AIM To investigate the factors associated with a decrease in the WHtR in newly diagnosed Chinese type 2 diabetes patients receiving acarbose or metformin monotherapy.METHODS At 24 wk,343 patients in the acarbose treatment and 333 patients in the metformin treatment were included in this analysis.On the basis of the reduction in the WHtR,these participants were divided into the following two groups:LowΔWHtR group and highΔWHtR group.Metabolic and related parameters associated with a highΔWHtR were investigated using univariate and multivariate logistic regression analyses.RESULTS A significant decrease in the WHtR was observed in both treatment groups(acarbose:-0.015,95%confidence interval[CI]:-0.018 to-0.012,P<0.001;metformin:-0.013,95%CI:-0.016 to-0.010,P<0.001).In both the acarbose and metformin groups,the WHtR of the women was more likely to be reduced than that of the men.In the acarbose group,a lower baseline area under the curve of glucagon-like peptide 1(AUCGLP-1)was associated with a highΔWHtR(odds ratio[OR]=0.796,P<0.001),while a higher baseline AUCGLP-1 was associated with a highΔWHtR in the patients treated with metformin(OR=1.133,P=0.025).Regarding the changes from baseline,an increase in AUCGLP-1 was associated with a highΔWHtR in the acarbose(OR=1.121,P=0.016)but not metformin group.A higher reduction in high-density lipoprotein cholesterol/non-highdensity lipoprotein cholesterol was also associated with a highΔWHtR in the acarbose arm(OR=20.735,P=0.001).In the metformin arm,a higher reduction in fasting plasma glucose(OR=0.843,P=0.039)and total cholesterol was associated with a highΔWHtR(OR=0.743,P=0.013).CONCLUSION A lower glucagon-like peptide 1 level and higher increase in glucagon-like peptide 1 are associated with a high reduction in the WHtR in newly diagnosed Chinese diabetes patients receiving treatment with acarbose.

Prevalence of Metabolic Syndrome in HIV-Infected Cameroonian Patients

Aims: Metabolic complications related to antiretroviral therapy are rarely investigated among HIV-infected patients in Cameroon. The study reports the prevalence of metabolic syndrome and its individual components among HIV-infected Cameroonians. Materials and Methods: We conducted a prospective, cross-sectional study of the prevalence of metabolic syndrome among 492 patients (338 women, 117 men;age range 20 years) recruited at a reference centre, the day hospital, Central Hospital in Yaounde between September 2009 and September 2010. Metabolic syndrome was defined according to IDF (International Diabetes Federation) and NCEP ATP III (National Cholesterol Education Program Adult Treatment Panel III) criteria relative to obesity, glycemic, lipid, arterial blood pressure parameters. Results: The prevalence of metabolic syndrome was 32.8% according to IDF and 30.7% by NCEP (p = 0.0001). The prevalences of individual components according to IDF and NCEP were as follows: abdominal obesity (40.5%;26.9% respectively), hypertriglyceridemia (55.5%), low HDL cholesterol (42.5%), systolic hypertension (38.2%) diastolic hypertension (28.5%), hyperglycemia (31.2%;1.3% p = 0.0001). The prevalence of metabolic syndrome was 36% in patients under HAART, 23.4% in naive, (p = 0.0001). Conclusion: The prevalence of metabolic syndrome depends on the presence and the type of HAART used, the definition and the gender.

Postprandial triglyceride metabolism in elderly men with subnormal testosterone levels

Aim： To investigate the level of postprandial triglycerides （TG）s in elderly men with subnormal testosterone level （≤ 11.0 nmol/L） compared to men with normal testosterone level （〉 11.0 nmol/L）. Methods： Thirthy-seven men with subnormal and 41 men with normal testosterone aged 60-80 years underwent an oral fat load and TG levels were measured fasting and 2, 4, 6 and 8 h afterwards. Results： Men with subnormal testosterone had significantly higher body mass index （BMI） and waist circumference （P 〈 0.001） than men with normal testosterone. They had significantly higher area under curve （AUC, P = 0.037）, incremental area under curve （AUCi, P = 0.035） and TG response （TGR, P = 0.014） for serum-TG and significantly higher AUC （P = 0.023）, AUCi （P = 0.023） and TGR （P = 0.014） for chylomicron-TG compared to men with normal testosterone level. Adjusting for waist circumference erased the significant differences between the groups in postprandial triglyceridemia. Conclusion： Men with subnormal testosterone have increased postprandial TG levels indicating an impaired metabolism of postprandial TG-rich lipoproteins （TRL）, which may add to an unfavourable lipid profile and promote development of atherosclerosis.

Nutritional and Metabolic Profile in Diabetic Patients and Relationship with Metabolic Syndrome

Background & Objectives: Diabetes and metabolic syndrome spread alarmingly throughout the whole world including Algeria, so our study makes the links closer between these two entities and that through studying nutritional, metabolic and physical profiles. Study Design: 204 patients were recruited and interviewed (anthropometric measurements, blood pressure, age, sex, personal and family history, the practice of physical activity and evaluation of food consumption). Patients and Methods: A cross-sectional survey was conducted in the western Algerian region (Sidi Bel Abbes). Patients with MetS are defined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Results: The results show that the frequency of the metabolic syndrome is 86.27% with predominance of women (92.15% women vs 80.39% men). The age group most affected by the MetS among women and men is [54 - 79] years. We also note that 51.28% of men present three criteria of MetS, while 65.21% of women have four and five criteria. The results show that the criteria most dominant in men are hypertension and type 2 diabetes, whereas in women, the high waist is the most abundant criterion. Moreover, the whole is underlined by a low physical activity with only 21.56% who practice it regularly (15.95% women vs 28.04% men). The estimate of food intake shows a qualitative imbalance: protein intake is 19.65% in women vs. 19.43% in men represented mainly by vegetable protein (83.72% for women vs. 72.85% for men);lipids intake is characterized by a lower consumption than the recommendation of the Mediterranean diet concerning the mono-unsaturated fatty acids (MUFA) (39.44% among women vs 40.24% at the men), as in poly unsaturated fatty-acids including (PUFA) (23.30% among women vs 23.64% at the men) whereas an increase in the consumption of the saturated fatty-acids (SFA) is observed in the whole population including (37.24% among women vs 36.10% at the men);lower concentration in calcium, magnesium and en fibers;important concentration of sodium and an insufficient contribution of water. Conclusion: We should be aware of the importance of the modulation of these risk factors through harmonization of “lifestyle” to prevent the occurrence of metabolic syndrome.

Midline Supraumbilical Incision as an Option for Morbidly Obese Patients? Case Report

Background: Nowadays we observe growing rates of obesity, mainly among women. It has a great impact on maternal and fetal morbimortality and requires a specific obstetric approach. Aim: To discuss different approaches to abdominal incision in cesarean section in obese patients. Case presentation: Patient with morbid obesity submitted to an elective cesarean section due to fetal macrosomia and who underwent a cesarean section with a supraumbilical median incision evolving without any postpartum complications. Conclusion: It’s important to evaluate and chose the best incision in morbidly obese pregnant women aiming to reduce difficulties in fetal extraction and postoperative complications. Midline supraumbilical incision is a good choice in these cases, reducing surgical time and postpartum hemorrhage.

Association between Chinese visceral adiposity index and risk of cardiometabolic multimorbidity in middle-aged and elderly Chinese population:Evidence from a national longitudinal study

Background There are several surrogate indicators of abdominal fat deposition,including tri-ponderal mass index(TMI),lipid accumulation product(LAP),and the Chinese visceral adiposity index(CVAI).In spite of this,it remains unclear whether these indices have a longitudinal relationship with the prevalence of cardiometabolic multimorbidity(CM),a pressing global health issue.This research investigated the association between CVAI and CM compared to other indicators of visceral obesity.Methods 6638 participants(aged>45)from the China Health and Retirement Longitudinal Study(CHARLS)were analyzed for incident CM.Cox proportional models were adopted to explore whether the level of CVAI was correlated with the risk of CM.Harrell's concordance statistic(C-statistic)was applied to compare predictive values.Sensitivity and subgroup analyses were implemented for the steadiness of the results.Results Over 4 years,266(4.01%)participants developed CM.A 1-standard deviation(SD)increase in the levels of CVAI,body mass index(BMI),LAP,and TMI was associated with greater CM risk after adjusting for confounders[hazard ratios(HRs):2.20,95%confidence interval(CI):1.88-2.57,1.92(95%CI:1.55-2.38),1.20(95%CI:1.12-1.27),and 1.50(95%CI:1.35-1.66),respectively].CVAI outperformed other indices in predictive performance.Subgroup analysis revealed younger participants or those living alone were more prone to developing CM.Results were potent after finishing all sensitivity analyses.Conclusions The study highlighted a positive correlation between the level of CVAI and CM risk.CVAI's superior predictive performance positions it as a reliable indicator for identifying individuals at heightened CM risk.

Clinical research on using acupuncture to treat female adult abdominal obesity with spleen deficiency and exuberant dampness

OBJECTIVE： To observe the curative effect of acu- puncture at hour-prescriptive points, a method of midnight-noon ebb-flow, to treat female adult ab- dominal obesity with spleen deficiency and exuber- ant dampness. METHODS： Seventy-two patients with adult ab- dominal obesity with spleen deficiency and exuber- ant dampness were randomly divided into a treat- ment group and a control group with 36 patients in each group. Patients in the treatment group were treated with acupuncture at hour-prescriptive points from 9 to 11 AM every day on the principle of taking points along channels in time. Patients in the control group were treated with acupuncture at any time beyond 9 to 11 AM. Patients in both groups were treated for three courses of treatment.treatment group and 78.8% in the control group. The total curative effect in the treatment group was significantly better than that in the control group in reducing body weight, body mass index, waistline, obesity level, and clinical symptoms （P〈0.05）. After treatment, t-test was used on two independent samples to analyze the ratio of waistline to hipline and hipline. A value of 0.01〈P〈0.05 expressed a weaker outcome and similar curative effect be- tween the two groups in reducing ratio of waistline to hipline and hipline of patients. This value indi- cates that the treatment group has no obvious su- periority to that of the control group for curative effect. CONCLUSION： Because it was superior in reducing waistline and body weight of female adult pa- tients suffering from abdominal obesity with spleen deficiency and exuberant dampness, acu- puncture at hour-prescriptive points, a method of midnight-noon ebb-flow, is an effective method to treat obesity.

Effects of Altered Intra-abdominal Pressure on the Upper Airway Collapsibility in a Porcine Model

Background： Obstructive sleep apnea is strongly associated with obesity, particularly abdominal obesity common in centrally obese males. Previous studies have demonstrated that intra-abdominal pressure （IAP） is increased in morbid obesity, and tracheal traction forces may influence pharyngeal airway collapsibility. This study aimed to investigate that whether IAP plays a role in the mechanism of upper airway （UA） collapsibility via IAP-related caudal tracheal traction. Methods： An abdominal wall lifting （AWL） system and graded CO2 pneumoperitoneum pressure was applied to four supine, anesthetized Guizhou miniature pigs and its effects on tracheal displacement （TD） and airflow dynamics of UA were studied. Individual run data in 3 min obtained before and after AWL and obtained before and after graded pneumoperitoneum pressure were analyzed. Differences between baseline and AWL/graded pneumoperitoneum pressure data of each pig were examined using a Student＇s t-test or analysis of variance. Results： Application of AWL resulted in decreased IAP and significant caudal TD. The average displacement amplitude was 0.44 mm （P 〈 0.001 ）. There were three subjects showed increased tidal volume （TV） （P 〈 0.01 ） and peak inspiratory airflow （P 〈 0.01 ）; however, the change of flow limitation inspiratory UA resistance （Rua） was not significant. Experimental increased lAP by pneumoperitoneum resulted in significant cranial TD. The average displacement amplitude was 1.07 mm （P 〈 0.001） when lAP was 25 cmH2O compared to baseline. There were three subjects showed reduced Rua while the TV increased （P 〈 0.01 ）. There was one subject had decreased TV and elevated Rua （P 〈 0.001）. Conclusions： Decreased IAP significantly increased caudal TD, and elevated lAP significantly increased cranial TD. However, the mechanism of UA collapsibility appears primarily mediated by changes in lung volume rather than tracheal traction effect. TV plays an independent role in the mechanism of UA collapsibility.

Gene-Gene Interaction between PPARd and PPARy Is Associated with Abdominal Obesity in a Chinese Population

The peroxisome proliferator-activated receptors （PPARs） -α, -δ/β and -γ are the ligand-activated transcription factors that function as the master regulators of glucose, fatty acid and lipoprotein metabolism, energy balance, cell proliferation and differentiation, inflarn- marion, and atherosclerosis. The objective of the current study was to examine the main and interactive effect of seven single nucleotide polymorphisms （SNPs） of PPARδ/γ, in contribution to abdominal obesity. A total of 820 subjects were randomly selected and no indi- viduals were related. The selected S NPs in PPARδ （rs2016520 and rs9794） and PPARγ （rs10865710, rs 1805192, rs709158, rs3856806, and rs4684847） were genotyped. Mean difference and 95% confident interval were calculated. Interactions were explored by the method of generalized multifactor dimensionality reduction. After adjustment for gender, age, and smoking status, it was found that the carriers of the C allele （TC ＋ CC） of rs2016520 were associated with a decreased risk of abdominal obesity compared to the carriers of the TT genotype （mean difference = -2.63, 95% CI = -3.61-1.64, P 〈 0.000t）. A significant two-locus model （P = 0.0107） involving rs2016520 and rs 10865710 and a significant three-locus model （P = 0.0107） involving rs2016520, rs9794, and rs 1805192 were observed. Overall, the three-locus model had the highest level of testing accuracy （59.85%） and showed a better cross-validation consistency （9/10） than two-locus model. Therefore, for abdominal obesity defined by waist circumference, we chose the three-locus model as the best interaction model. In conclusion, the C allele in rs2016520 was significantly associated with a lower abdominal obesity. Moreover, an interaction among rs2016520, rs1805192, and rs9794 on incident abdominal obesity could be demonstrated.