Predictive Ability of Hypertriglyceridemic Waist,Hypertriglyceridemic Waist-to-Height Ratio,and Waist-to-Hip Ratio for Cardiometabolic Risk Factors Clustering Screening among Chinese Children and Adolescents

Objective Hypertriglyceridemic waist(HW),hypertriglyceridemic waist-to-height ratio(HWHtR),and waist-to-hip ratio(WHR)have been shown to be indicators of cardiometabolic risk factors.However,it is not clear which indicator is more suitable for children and adolescents.We aimed to investigate the relationship between HW,HWHtR,WHR,and cardiovascular risk factors clustering to determine the best screening tools for cardiometabolic risk in children and adolescents.Methods This was a national cross-sectional study.Anthropometric and biochemical variables were assessed in approximately 70,000 participants aged 6–18 years from seven provinces in China.Demographics,physical activity,dietary intake,and family history of chronic diseases were obtained through questionnaires.ANOVA,χ2 and logistic regression analysis was conducted.Results A significant sex difference was observed for HWHtR and WHR,but not for HW phenotype.The risk of cardiometabolic health risk factor clustering with HW phenotype or the HWHtR phenotype was significantly higher than that with the non-HW or non-HWHtR phenotypes among children and adolescents(HW:OR=12.22,95%CI:9.54-15.67;HWHtR:OR=9.70,95%CI:6.93-13.58).Compared with the HW and HWHtR phenotypes,the association between risk of cardiometabolic health risk factors(CHRF)clustering and high WHR was much weaker and not significant(WHR:OR=1.14,95%CI:0.97-1.34).Conclusion Compared with HWHtR and WHR,the HW phenotype is a more convenient indicator with higher applicability to screen children and adolescents for cardiovascular risk factors.

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.

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.

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.

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.

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.

Cut-off of body mass index and waist circumference to predict hypertension in Indian adults

AIM: To determine the cut-off values of body mass index(BMI) and waist circumference to predict hypertension in adults in north India.METHODS: A community based cross-sectional study was conducted in 801 subjects in Kanpur, aged 20 years and above, using multistage stratified random sampling technique. A pre-tested structured question-naire was used to elicit the required information from the study participants and the diagnostic criteria for hypertension were taken according to the Seventh Joint National Committee Report on Hypertension(JNC-7). Receiver operating characteristic(ROC) analysis was used to estimate the cut-off values of BMI and waist circumference to predict hypertension.RESULTS: The ROC analysis revealed that BMI is a good predictor of hypertension for both men(area under the ROC curve 0.714) and women(area under the ROC curve 0.821). The cut-off values of BMI for predicting hypertension were identified as ≥ 24.5 kg/m2 in men and ≥ 24.9 kg/m2 in women. Similarly, the ROC analysis for waist circumference showed that it is a good predictor of hypertension both for men(area under the ROC curve 0.784) and women(area under the ROC curve 0.815). The cut-offs for waist circumference for predicting hypertension were estimated as ≥ 83 cm for men and ≥ 78 cm for women. Adults with high BMI or high waist circumference had a higher prevalence of hypertension, respectively.CONCLUSION: Simple anthropometric measurements such as BMI and waist circumference can be used for screening people at increased risk of hypertension in order to refer them for more careful and early diagnostic evaluation. Policies and programs are required for primary and secondary prevention of hypertension.

Performance of waist circumference relative to BMI in predicting risk of obesity and hypertension among affluent Indian adults

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.

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 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.

The effect of waist twisting on walking speed of an amphibious salamander like robot

Amphibious salamanders often swing their waist to coordinate quadruped walking in order to improve their crawling speed. A robot with a swing waist joint, like an amphibious salamander, is used to mimic this locomotion.A control method is designed to allow the robot to maintain the rotational speed of its legs continuous and avoid impact between its legs and the ground. An analytical expression is established between the amplitude of the waist joint and the step length. Further, an optimization amplitude is obtained corresponding to the maximum stride. The simulation results based on automatic dynamic analysis of mechanical systems（ADAMS） and physical experiments verify the rationality and validity of this expression.

Experimental Characterization of Operation of a Waist-Trunk System with Parallel Manipulators

An extensive research activity has been focused on the upper and lower limbs of humanoid robots. However, due to mechanical design difficulties and complex control of multi-body system, the torso of humanoid robot is somehow a neglected or simplified design part. In this paper, operation performance of a new waist-trunk system as torso for humanoid robots is presented through results of lab experimental tests. The proposed waist-trunk system is composed of two 3 DOFs （degrees of freedom） parallel manipulators, which are connected in a serial chain architecture. A prototype is built by using two prototypes of CaPaMan （Cassino Parallel Manipulator）, which are convenient stiff architectures with easy-operation characteristics. Experimental tests are carried out with the aims to imitate lateral-bending and transverse-rotation movements of human torso. Operation performances like displacements, accelerations, and actuation torque are measured for a performance evaluation and design characterization of the used manipulator solution imitating human torso. Experimental test results are illustrated and discussed to show the practical operation feasibility of the proposed architecture and the operation characteristics of the built prototype.

Determination of the Optimal Waist Circumference Cut-Off Points in Benin Adults

Obesity is an independent risk factor for chronic diseases such as diabetes, cardiovascular diseases and certain cancers. Early detection of abdominal obesity followed by appropriate interventions will prevent associated diseases. The objective was to determine optimal waist circumference (WC) cut-off points predictive of at least one other component of metabolic syndrome in Benin adults. This longitudinal and observational study included at the baseline 541 apparently healthy subjects aged 25 - 60 years randomly selected in the largest city of Cotonou (n = 200), the smaller-size city of Ouidah (n = 171) and rural surroundings of Ouidah (n = 170) in Benin. Components of the metabolic syndrome considered along with abdominal obesity were high blood pressure, high fasting glycaemia, low HDL-cholesterol and high triglycerides as defined by the Joint Interim Statement. After the baseline survey, the subjects were followed-up for four years. Complete data at baseline and four years later were available in 416 subjects. The receiver operating characteristic (ROC) curve for waist circumference to predict at least one other component of the metabolic syndrome was plotted and the Youden index was used to define the optimal cut-offs of WC. At the baseline of the study, the optimal WC cut-off point to predict the presence of at least one other component of the metabolic syndrome was 80 cm for men (sensitivity = 0.62, specificity = 0.65);the area under the ROC curve was 0.67 (IC 95%: 0.61-0.74). In women, the optimal WC cut-off point was 90 cm (sensitivity = 0.54, specificity = 0.80), and the area under the ROC curve was 0.68 (IC 95%: 0.62-0.75). These optimal cut-offs were similar four years later. Optimum WC cut-off points for both men and women in Benin differ from those currently recommended for sub-Saharan Africans. Therefore, waist circumference cut-off points for abdominal obesity need to be reconsidered for these populations.

Relationship of Serum Leptin, BMI, Waist Circumference and Cholesterol Level among Teenagers in the Gaza Strip

Leptin is one of the best known hormone markers for obesity. There is a limited anthropometric data in the Gaza Strip that reveals and arouses the nutritional status among all age groups especially adolescents aged 15 - 19 years old. The study aimed to assess the effect of Leptin hormone, lipid profiles, Body Mass Index (BMI) and waist circumference among secondary school age students in the Gaza Strip. Methodology: A cross sectional study included 442 cases of teenagers aged 15 - 19 years old from governmental and private schools in the Gaza strip. Blood samples were collected for analysis of Leptin hormone and lipid profile and measuring waist circumference for the teenager. Results: The mean of serum Leptin was (28.7) higher among cases than controls (28.1), but it was statistically insignificant (P = 0.85). It was found that there is a significant correlation between Leptin hormone and total cholesterol (Chol) (r = 0.24), high density cholesterol (HDL) (r = 0.27) and low density cholesterol (LDL) (r = 0.16). There was no relationship between Leptin hormone and triglycerides (TG) (r = -0.02). There was relationship between Leptin hormone and waist circumference in both males and females (r = 0.519, 0.544), respectively. There was no statistical significant deference noticed between Leptin hormone of obese objects and Leptin hormone of normal BMI objects of the same age (t-test = 0.93, P = 0.85). Conclusion: There are significant correlations between Leptin hormone and total Chol, HDL and LDL except for TG, and there were significant relationships between Leptin hormone and waist circumference which reflect the central obesity among males and females. There is no association between Leptin level and BMI.

Correlations of Body Mass Index, Japan-Defined and IDF-Defined Waist Circumference, Visceral and Subcutaneous Fat Area with Metabolic Parameters in Japanese Patients with Type 2 Diabetes

Obesity is included in the definition of metabolic syndrome. However, there are many controversies surrounding the evaluation of obesity such as body mass index (BMI) and waist circumference (WC) in the definition of metabolic syndrome among various populations. To understand precisely how various anthropometric indices of obesity influence metabolic parameters, we studied the correlations of BMI, WC (Japanese criteria), WC (IDF criteria), visceral fat area (VFA), subcutaneous fat area (SFA) and the VFA/SFA ratio with metabolic parameters in patients with type 2 diabetes. The influences of BMI and WC on diastolic blood pressure and HDL-cholesterol were larger than VFA, whereas the influences of visceral fat area on triglyceride, very low-density lipoprotein-cholesterol, C-peptide and high-sensitivity C-reactive protein were larger than BMI and WC. WC (IDF) was the strongest determinant of adiponectin among anthropometric indices. Present study showed significant different associations of BMI, Japan- and IDF-defined WC, VFA, SFA and the VFA/SFA ratio with blood pressure, glucose and lipid metabolism, and adipocytokines in Japanese patients with type 2 diabetes.

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.

Test of Normality of Waist Measurement Data of Young Male and Female Adults based on the Quantile - Quantile Plot

This paper investigates the normality of some real data set obtained from waist measurements of a group of 49 young adults. The quantile - quantile （Q-Q） plot and the analysis of correlation coefficients for the Q-Q plot is used to determine the normality or otherwise of the data set. In this regards, the probabilities of the quantiles were computed, modified and plotted. Thereafter the correlation coefficients for the quantile - quantile plots were obtained. Results indicate that at 0.1 level of significance, the data for young adult males of the sample were not normally distributed, and had a mean value that is within the range of low risk, healthwise, whereas the distribution of the data for young female adults showed reasonable normality, but also with a mean value that is within the range of low risk in terms of health condition.

The Research on Historical Evolution and Inheritance Development of Ansai waist drum in China

This article from the perspective of sports science and sociology to explain the origin and development ofansai waist drum, analyzes the historical evolution of ansai waist drum, analysis of ansai waist drum in problems existing in the process of development, and according to the analysis and the reality put forward the countermeasures of development of ansai waist drum inheritance： transmission of ansai waist drum based on school, and innovation of art form, ＂waist drum troupe＂ building, the establishment of various rules and regulations and the drummer cultivation mechanism and strengthening network, books, magazines and other publicity and performances.

Analysis of Ankle-Brachial Index, Waist-Hip Ratio, Ejection-Fraction, Obesity, Smoking, Alcohol Habits, Diabetes and Hypertension as Independent Predictors of Complexity and Severity of Coronary Artery Disease

Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and complexity of coronary artery disease. Methods: Patients diagnosed with coronary artery disease at our hospital between September-2012 and December-2014 were examined in this study. Selected patients were screened for cardiovascular risk factors including diabetes, hypertension, smoking, and alcohol habits as well as for clinical parameters including body-mass index, waist-hip ratio, ankle-brachial index, and ejection fraction. All patients underwent coronary angiography and were evaluated for severity of coronary artery disease (based on number of vessels involved) and complexity of coronary angiographic lesions (measured by computer-assisted Syntax score calculator). The collected data were analyzed to determine the role of cardiovascular risk factors and clinical parameters as predictors of complexity and severity of coronary artery disease. Results: A total of 211 patients (mean age: 54.64 ± 9.9 years;81% males) with coronary artery disease were analyzed. Findings revealed that diabetes mellitus (p < 0.001), hypertension (p < 0.001), smoking habits (p = 0.036), and low ankle-brachial index (p < 0.001) were independent predictors of complex coronary artery disease as measured by Syntax score. Significant associations were also evident between severity of coronary artery disease and diabetes mellitus (p < 0.001), hypertension (p < 0.001), and ankle-brachial index (p < 0.001). Conversely, other cardiovascular risk factors including body-mass index, alcohol habits, wait-hip ratio, and ejection fraction did not exhibit significant associations with severity and complexity of coronary artery. Conclusions: The early diagnosis of coronary artery can be predicated by evaluating diabetes, hypertension, and smoking habits in patients presenting with acute coronary syndrome. In addition, ankle-brachial index can be used as an effective non-invasive bed-side tool, as an alternative to Syntax score, in predicting the severity and complexity of coronary artery disease.