RESUMEN
La evaluación de la marcha en cinta caminadora puede resultar relevante para la toma de decisiones clínicas. No obstante, factores demográficos como la edad y el IMC pueden alterar la interpretación de los resultados. Nuestro objetivo fue obtener variables espacio- temporales, energéticas y costo de transporte durante la velocidad autoseleccionada en cinta caminadora para una muestra representativa de adultos uruguayos (n=28) y evaluar si diferentes rangos de edades e IMC pueden ser factores a tener en cuenta en pruebas clínicas donde se consideren dichas variables. Participaron 17 hombres y 11 mujeres (39,3 ± 14,8 años, 75,9 ± 12,5 kg, 1,74 ± 0,09 m, IMC 25,2 ± 4,06). Se realizó una reconstrucción 3D del movimiento en forma sincronizada con el consumo energético. Se obtuvieron valores de referencia y luego de agrupar los participantes según su IMC y rango de edad se compararon los datos mediante test de t (p≤0.05). Los resultados revelaron discrepancias significativas en las medidas espacio-temporales y energéticas de los adultos uruguayos al caminar en cinta con respecto a la literatura. La marcha difiere entre adultos jóvenes y de mediana edad en su velocidad autoseleccionada (p=0,03), longitud de zancada (p=0,01), trabajo mecánico externo (<0,001) y recuperación de energía mecánica (0,009), destacando la importancia de considerar la edad en evaluaciones clínicas. El IMC no influyó significativamente en estas variables. Estos hallazgos subrayan la necesidad de ajustar las interpretaciones de las pruebas clínicas de la marcha sobre cinta caminadora en adultos uruguayos de mediana edad (45 a 65 años).
Treadmill gait assessment can be relevant for clinical decision-making. However, demographic factors such as age and BMI may alter result interpretation. Our aim was to obtain spatiotemporal, energetic, and cost of transport variables during self-selected treadmill walking speed for a representative sample of Uruguayan adults (n=28) and to assess if different age ranges and BMI could be factors to consider in clinical tests involving these variables. Seventeen men and eleven women participated (39.3 ± 14.8 years, 75.9 ± 12.5 kg, 1.74 ± 0.09 m, BMI 25.2 ± 4.06). A synchronized 3D motion reconstruction was performed with energy consumption. Reference values were obtained and data were compared using t-tests (p≤0.05), after grouping participants by BMI and age range. Results revealed significant discrepancies in spatiotemporal and energetic measures of Uruguayan adults walking on the treadmill, compared to the literature. Gait differed between young and middle-aged adults in their self-selected speed (p=0.03), stride length (p=0.01), external mechanical work (p<0.001), and mechanical energy recovery (0.009), emphasizing the importance of considering age in clinical evaluations. BMI did not significantly influence these variables. These findings underscore the need to adjust interpretations of treadmill gait clinical tests in middle-aged Uruguayan adults (45 to 65 years).
A avaliação da marcha na esteira pode ser relevante para a tomada de decisões clínicas. No entanto, fatores demográficos como idade e IMC podem alterar a interpretação dos resultados. Nosso objetivo foi obter variáveis espaço-temporais, energéticas e custo de transporte durante a velocidade de caminhada autoselecionada na esteira para uma amostra representativa de adultos uruguaios (n = 28) e avaliar se diferentes faixas etárias e IMC podem ser fatores a serem considerados em testes clínicos que envolvam essas variáveis. Dezessete homens e onze mulheres participaram (39,3 ± 14,8 anos, 75,9 ± 12,5 kg, 1,74 ± 0,09 m, IMC 25,2 ± 4,06). Foi realizada uma reconstrução tridimensional do movimento sincronizada com o consumo de energia. Foram obtidos valores de referência e os dados foram comparados usando testes t (p≤0,05), após agrupar os participantes por IMC e faixa etária. Os resultados revelaram discrepâncias significativas nas medidas espaço-temporais e energéticas dos adultos uruguaios ao caminhar na esteira, em comparação com a literatura. A marcha diferiu entre adultos jovens e de meia-idade em sua velocidade autoselecionada (p=0,03), comprimento da passada (p=0,01), trabalho mecânico externo (<0,001) e recuperação de energia mecânica (0,009), destacando a importância de considerar a idade em avaliações clínicas. O IMC não influenciou significativamente essas variáveis. Esses achados destacam a necessidade de ajustar as interpretações dos testes clínicos de marcha na esteira em adultos uruguaios de meia- idade (45 a 65 anos).
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Composición Corporal/fisiología , Caminata/fisiología , Prueba de Esfuerzo/estadística & datos numéricos , Índice de Masa Corporal , Distribución por EdadRESUMEN
Introduction: obstructive sleep apnea syndrome (OSAS) is the most common sleep-related breathing disorder. Knowledge about OSAS incidence trends could be extremely useful in assessing health needs and implementing preventive measures accordingly. This study aimed at the epidemiological and clinical specificities of OSAS and to give an update on its current chronological trends. Methods: we conducted a retrospective study including all cases of OSAS diagnosed over 11 years, from January 1, 2012, to December 31, 2022, at the Sleep Unit of the Neurophysiology Department of the Sahloul University Hospital, Tunisia. Results: overall, 848 new cases of OSAS were diagnosed. The mean annual number of OSAS cases was 74.8/year. The crude incidence rate (CIR) was 12.3/100000 inhabitants/year, it was significantly increasing over the years (rho=0.7; p=0.01). The median age was 56 (IQR= [48-64]) years, it increased significantly during the study period from 54 years (IQR= [43-63]) in 2012 to 58 years (IQR= [50.5-65]) in 2022 (rho=0.7; p=0.015). The median BMI was 35.5 (IQR= [31.3-40.3]) kg/m2. The median BMI of patients diagnosed with OSAS increased significantly from 34.6 kg/m2 to 38.3 kg/m2 (rho=0.75; p=0.008). This equated to an annual increase in median BMI of 0.41 kg/m2. The median AHI showed a significant upward trend for all patients, rising from 26.30 events/h in 2012 to 34.07 events/h in 2022 (rho=0.68; p=0.02). Conclusion: the CIR of OSAS is related to BMI and age. Thus, we assume that it will continue to increase in the coming years with the rise in obesity and the aging of the population.
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Índice de Masa Corporal , Apnea Obstructiva del Sueño , Humanos , Apnea Obstructiva del Sueño/epidemiología , Túnez/epidemiología , Estudios Retrospectivos , Masculino , Persona de Mediana Edad , Femenino , Adulto , Incidencia , Anciano , Obesidad/epidemiología , Factores de RiesgoRESUMEN
BACKGROUND AND AIMS: Epidemiological evidence on the associations between female reproductive features and nonalcoholic fatty liver disease (NAFLD) is conflicting. To explore their causalities, we conducted a Mendelian randomization (MR) study. METHODS: Summary-level data were obtained, and univariable MR was performed to explore the causalities between female reproductive features and NAFLD. And we performed multivariable MR and MR mediation analysis to explore the mediation effects of educational attainment (EA) and body mass index (BMI) for these associations. Sensitivity analyses were performed to evaluate pleiotropy and heterogeneity. RESULTS: There were causal effects of age at menarche (AAMA) (odds ratio [OR]: 0.817, 95% confidence interval [CI]: 0.736-0.907, per year-increase), age at first birth (AFB) (OR: 0.851, 95%CI: 0.791-0.926, per year-increase) and age at first sexual intercourse (AFS) (OR: 0.676, 95%CI: 0.511-0.896, per standard deviation-increase) on NAFLD risk. Besides, the causal effects were also observed on NAFLD phenotypes including liver fat content (LFC) and alanine aminotransferase (ALT). Further mediation analysis showed that BMI mediated partial proportion of effects of AAMA and AFS on NAFLD/ALT, AFB on NAFLD/LFC/ALT, while EA mediated partial proportion of effects of AFB on NAFLD/LFC/ALT, and AFS on NAFLD/ALT. CONCLUSIONS: This study provided convincing evidence that early AAMA, AFB, and AFS were risk factors for NAFLD. Reproductive health education, obesity management, and education spread might be the beneficial strategies for NAFLD prevention.
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Índice de Masa Corporal , Análisis de la Aleatorización Mendeliana , Enfermedad del Hígado Graso no Alcohólico , Humanos , Enfermedad del Hígado Graso no Alcohólico/genética , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Enfermedad del Hígado Graso no Alcohólico/etiología , Femenino , Factores de Riesgo , Menarquia , Reproducción/genética , Polimorfismo de Nucleótido Simple , Predisposición Genética a la Enfermedad , Oportunidad RelativaRESUMEN
BACKGROUND: Elevated liver enzyme levels have been associated with metabolic syndrome in both obese and non-obese pediatric populations. This study aims to compare the serum liver enzyme levels in obese adolescents with and without insulin resistance (IR). METHODS: A cross-sectional analysis was conducted involving obese adolescents aged 10-18. We assessed somatometry, serum insulin levels, lipid profiles, and liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and gamma-glutamyl transferase [GGT]). Statistical differences between groups were evaluated using Student's t-test or the Chi-squared test, with IR (wIR) status matched by propensity scores based on body mass index (BMI) z-scores. RESULTS: The study included 365 adolescents with obesity, 229 wIR, and 136 without (woIR). Before matching, the wIR group had a significantly higher BMI z-score (2.21 vs. 2.14, p = 0.032). After matching for BMI z-scores (n = 122 each group), the wIR group displayed significantly higher levels of AST (32.3 vs. 24.7, p < 0.001) and ALT (42.4 vs. 30.9, p < 0.001), but no significant differences were observed in GGT levels (37.4 vs. 32.5, p = 0.855). CONCLUSION: Obese adolescent's wIR exhibit higher serum ALT and AST levels, suggesting that altered AST is a potential risk factor for IR.
INTRODUCCIÓN: Se ha observado asociación entre niveles elevados de enzimas hepáticas y síndrome metabólico en población pediátrica con y sin obesidad. El objetivo del estudio fue comparar los niveles séricos de enzimas hepáticas entre adolescentes con obesidad con y sin resistencia a la insulina (RI). MÉTODOS: Se realizó un estudio transversal en adolescentes con obesidad entre 10 y 18 años. Se analizaron los datos somatometricos, insulina sérica, perfil lipídico y niveles de enzimas hepáticas (aspartato aminotransferasa [AST], alanina aminotransferasa [ALT] y gamma-glutamil transferasa [GGT]). Análisis estadístico: se utilizó t de Student o la prueba de Chi-cuadrado para evaluar diferencias entre grupos. Los pacientes con RI se emparejaron con pacientes sin RI utilizando puntuaciones de propensión basadas en la puntuación z del IMC. RESULTADOS: Se incluyeron un total de 365 adolescentes con obesidad (229 con RI y 136 sin RI). El grupo con RI tuvo un IMC mayor (con RI 2.21 vs sin RI 2.14 p = 0.032). Después de emparejar los grupos según el IMCz (n = 122 por grupo), el grupo con RI tuvo niveles de AST (24.7 vs., 32.3, p < 0.001) y ALT (30.9 vs., 42.4, p < 0.001) significativamente más altos en comparación al grupo sin RI. Sin embargo, no hubo diferencia en los niveles de GTT (37.4 vs 32.5, p = 0.855). CONCLUSIONES: Los niveles séricos de ALT y AST en adolescents con obesidad y RI fueron mayores. La AST alterada fue un factor de riesgo para presentar RI.
Asunto(s)
Alanina Transaminasa , Aspartato Aminotransferasas , Índice de Masa Corporal , Resistencia a la Insulina , Hígado , Obesidad Infantil , Puntaje de Propensión , gamma-Glutamiltransferasa , Humanos , Adolescente , Estudios Transversales , Femenino , Masculino , Alanina Transaminasa/sangre , Niño , Aspartato Aminotransferasas/sangre , gamma-Glutamiltransferasa/sangre , Hígado/enzimología , Síndrome Metabólico/sangre , Insulina/sangreAsunto(s)
Asma , Sobrepeso , Humanos , Asma/epidemiología , Asma/complicaciones , Niño , Masculino , Femenino , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Adolescente , Índice de Masa CorporalRESUMEN
BACKGROUND: Elevated body mass index (BMI) is a known perioperative risk factor for complications such as delayed wound healing and infection. However, there is a gap in understanding how elevated BMI impacts outcomes after posttraumatic lower extremity (LE) microvascular reconstruction. METHODS: A retrospective review was performed at a level 1 trauma center between 2007 and 2022 of patients who underwent posttraumatic microvascular LE reconstruction. Demographics, flap/wound details, complications, and outcomes were recorded. Patients were stratified into BMI Center for Disease Control categories. RESULTS: A total of 398 patients were included with an average BMI of 28.2 ± 5.8. Nearly half (45%) of LE defects were located in the distal third of the leg, 27.5% in the middle third, and 34.4% in the proximal third. Most reconstructions utilized muscle-containing flaps (74.4%) compared with fasciocutaneous flaps (16.8%). Surgical approaches included free flaps (47.6%) and local flaps (52.5%). Class III obese patients were significantly more likely to be nonambulatory than nonobese patients (OR: 4.10, 95% CI 1.10-15.2, p = 0.035). At final follow-up, 30.1% of patients with Class III obesity were ambulatory, requiring either wheelchairs (42.3%) or assistance devices (26.9%). There were no significant differences in complication rates based on obesity status (0.704). The average follow-up time for the entire cohort was 5.8 years. CONCLUSIONS: BMI is critical for patient care and surgical decision-making in LE reconstruction. Further research is warranted to optimize outcomes for higher BMI patients, thereby potentially reducing the burden of postoperative complications and enhancing overall patient recovery.
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Índice de Masa Corporal , Traumatismos de la Pierna , Microcirugia , Procedimientos de Cirugía Plástica , Complicaciones Posoperatorias , Humanos , Masculino , Estudios Retrospectivos , Femenino , Adulto , Microcirugia/métodos , Microcirugia/efectos adversos , Procedimientos de Cirugía Plástica/métodos , Procedimientos de Cirugía Plástica/efectos adversos , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Traumatismos de la Pierna/cirugía , Resultado del Tratamiento , Obesidad/complicaciones , Extremidad Inferior/cirugía , Factores de Riesgo , Colgajos Tisulares Libres/trasplante , Colgajos Tisulares Libres/irrigación sanguínea , Colgajos Tisulares Libres/efectos adversos , Colgajos Quirúrgicos/irrigación sanguínea , Colgajos Quirúrgicos/trasplante , Colgajos Quirúrgicos/efectos adversosRESUMEN
Background: Firefighters have lower levels of physical activity while on call. It is critical to understand the impact of firefighters' physical activity on arterial stiffness. This study classified groups by physical activity level and combined peripheral vascular monitor measurement to explore the relationships between the level of physical activity and cardiovascular (CV) risk and physical fitness (PF) of firefighters, as well as the acute response to arterial stiffness (AS) following maximal aerobic exercise test (MAET) intervention. Methods: The International Physical Activity Questionnaire (IPAQ) was used to classify the participants into 3 groups: low, moderate, and high level of physical activity group, respectively. A total of 36 participants were recruited, 12 in each group. Participants were assessed for body composition, rest brachial-ankle pulse wave velocity (baPWV), handgrip strength (HGS), maximal oxygen uptake (VÌO2max), and MAET baPWV. Results: In the three groups, significant differences were observed in VÌO2max, HGS, relative fat mass (%FM), body mass index (BMI), muscle mass ratio (MMR), and Rest baPWV (p < 0.05). After maximal aerobic exercise, the MAET baPWV values decreased significantly in all groups (all p < 0.001). Rest baPWV was significantly correlated with firefighters' age, seniority, metabolic equivalents (METs), height and muscle mass (MM) (p < 0.05). Conclusions: Firefighters with high levels of physical activity had better body composition and physical fitness and lower Rest baPWV. In all three groups, baPWV was lower after the MAET than before it. Therefore, regardless of a firefighter's level of physical activity, high-intensity aerobic exercise may have a beneficial effect on arterial stiffness.
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Ejercicio Físico , Bomberos , Aptitud Física , Rigidez Vascular , Humanos , Rigidez Vascular/fisiología , Masculino , Adulto , Aptitud Física/fisiología , Ejercicio Físico/fisiología , Análisis de la Onda del Pulso , Composición Corporal/fisiología , Prueba de Esfuerzo/métodos , Fuerza de la Mano/fisiología , Consumo de Oxígeno/fisiología , Persona de Mediana Edad , Índice de Masa Corporal , Índice Tobillo Braquial , Femenino , Encuestas y CuestionariosRESUMEN
INTRODUCTION: Obstetrics research has predominantly focused on the management and identification of factors associated with labor dystocia. Despite these efforts, clinicians currently lack the necessary tools to effectively predict a woman's risk of experiencing labor dystocia. Therefore, the objective of this study was to create a predictive model for labor dystocia. MATERIAL AND METHODS: The study population included nulliparous women with a single baby in the cephalic presentation in spontaneous labor at term. With a cohort-based registry design utilizing data from the Copenhagen Pregnancy Cohort and the Danish Medical Birth Registry, we included women who had given birth from 2014 to 2020 at Copenhagen University Hospital-Rigshospitalet, Denmark. Logistic regression analysis, augmented by a super learner algorithm, was employed to construct the prediction model with candidate predictors pre-selected based on clinical reasoning and existing evidence. These predictors included maternal age, pre-pregnancy body mass index, height, gestational age, physical activity, self-reported medical condition, WHO-5 score, and fertility treatment. Model performance was evaluated using the area under the receiver operating characteristics curve (AUC) for discriminative capacity and Brier score for model calibration. RESULTS: A total of 12,445 women involving 5,525 events of labor dystocia (44%) were included. All candidate predictors were retained in the final model, which demonstrated discriminative ability with an AUC of 62.3% (95% CI:60.7-64.0) and Brier score of 0.24. CONCLUSIONS: Our model represents an initial advancement in the prediction of labor dystocia utilizing readily available information obtainable upon admission in active labor. As a next step further model development and external testing across other populations is warranted. With time a well-performing model may be a step towards facilitating risk stratification and the development of a user-friendly online tool for clinicians.
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Índice de Masa Corporal , Distocia , Edad Materna , Paridad , Humanos , Femenino , Embarazo , Distocia/epidemiología , Adulto , Factores de Riesgo , Dinamarca/epidemiología , Curva ROC , Inicio del Trabajo de Parto , Sistema de Registros , Edad GestacionalRESUMEN
This study addresses the pressing need for improved methods to predict lean mass in adults, and in particular lean body mass (LBM), appendicular lean mass (ALM), and appendicular skeletal muscle mass (ASMM) for the early detection and management of sarcopenia, a condition characterized by muscle loss and dysfunction. Sarcopenia presents significant health risks, especially in populations with chronic diseases like cancer and the elderly. Current assessment methods, primarily relying on Dual-energy X-ray absorptiometry (DXA) scans, lack widespread applicability, hindering timely intervention. Leveraging machine learning techniques, this research aimed to develop and validate predictive models using data from the National Health and Nutrition Examination Survey (NHANES) and the Action for Health in Diabetes (Look AHEAD) study. The models were trained on anthropometric data, demographic factors, and DXA-derived metrics to accurately estimate LBM, ALM, and ASMM normalized to weight. Results demonstrated consistent performance across various machine learning algorithms, with LassoNet, a non-linear extension of the popular LASSO method, exhibiting superior predictive accuracy. Notably, the integration of bone mineral density measurements into the models had minimal impact on predictive accuracy, suggesting potential alternatives to DXA scans for lean mass assessment in the general population. Despite the robustness of the models, limitations include the absence of outcome measures and cohorts highly vulnerable to muscle mass loss. Nonetheless, these findings hold promise for revolutionizing lean mass assessment paradigms, offering implications for chronic disease management and personalized health interventions. Future research endeavors should focus on validating these models in diverse populations and addressing clinical complexities to enhance prediction accuracy and clinical utility in managing sarcopenia.
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Absorciometría de Fotón , Composición Corporal , Aprendizaje Automático , Músculo Esquelético , Encuestas Nutricionales , Sarcopenia , Humanos , Músculo Esquelético/diagnóstico por imagen , Masculino , Femenino , Absorciometría de Fotón/métodos , Persona de Mediana Edad , Sarcopenia/diagnóstico , Sarcopenia/diagnóstico por imagen , Sarcopenia/patología , Adulto , Anciano , Índice de Masa CorporalRESUMEN
Weight-adjusted-waist index (WWI) is an emerging parameter for evaluating obesity. We sought to ascertain the link between WWI and circadian syndrome (CircS). The study population consisted of 8275 eligible subjects who were included in the ultimate analysis from the NHANES 2011-2018. By using multivariable regression models, the association of WWI and CircS was analyzed. In subgroup analysis, we explored the relationship in different groups and tested the stability of the intergroup connection using interaction testing. To investigate whether WWI and CircS had a potential non-linear relationship, smooth curve fittings, and threshold effects tests were also constructed. In a multivariate linear regression model, WWI is significantly positively related to CircS (OR = 1.77, 95% CI 1.50-2.08). Through subgroup analysis and interaction testing, the stability of this positive association was also validated. It was further found that there was an inverted U-shaped association, with a turning point of 11.84, between WWI and CircS. Our findings supported a strong association between WWI values and CircS. Central obesity management is pivotal for preventing or alleviating CircS.
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Circunferencia de la Cintura , Humanos , Masculino , Femenino , Persona de Mediana Edad , Adulto , Peso Corporal , Obesidad/epidemiología , Trastornos Cronobiológicos/fisiopatología , Índice de Masa Corporal , Anciano , Encuestas NutricionalesRESUMEN
Although there is an association between income status and concentration of perfluoroalkyl and polyfluoroalkyl substance (PFAS), the association remains uncertain in patients with hypertension, hyperlipidemia, and comorbidities. Data from the 2013-2016 National Health and Nutrition Examination Survey were analyzed. A total of 2665 adults were included, and the data included participants' serum PFAS (perfluorooctanoic acid [PFOA], perfluorononaic acid, perfluorodecanoic acid, perfluoroundecanoic acid, perfluorohexane sulfonic acid, and perfluorooctane sulfonic acid) levels and selected covariates. Multivariate linear regression models were used to examine the association between the ratio of family income to poverty (PIR) and individual serum PFAS concentrations in the hypertensive and/or hyperlipidemia groups after adjusting for covariates. The potential effects of sex and age on the results were explored using stratified analysis. A mediating effect model was used to explore the mediating effects of body mass index (BMI) and waist circumference on the association results. After adjusting for potential confounders, for hyperlipidemia and comorbidities (hypertension and hyperlipidemia), serum levels of multiple common PFAS increased by 0.09% (95%Confidence interval [CI] 0.02-0.15%) to 0.13% (95%CI 0.08-0.19%) and 0.10% (95%CI 0.02-0.17%) to 0.12% (95%CI 0.06-0.18%), respectively, with each 1% increase in PIR. The covariate model and stratified analyses results suggested the potential effects of different covariates such as age and sex, leading to changes in the statistical significance of the association results. BMI significantly mediated the effect of PIR on PFOA in hyperlipidemia (13%, P < 0.001). Household income in adults with hyperlipidemia and comorbidities positively correlated with serum PFAS concentration in the United States. Obesity played an indispensable mediating role in the association between economic income and PFAS concentration.
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Fluorocarburos , Hiperlipidemias , Hipertensión , Humanos , Femenino , Masculino , Fluorocarburos/sangre , Hipertensión/sangre , Hipertensión/epidemiología , Persona de Mediana Edad , Adulto , Hiperlipidemias/sangre , Hiperlipidemias/epidemiología , Estados Unidos/epidemiología , Encuestas Nutricionales , Anciano , Ácidos Alcanesulfónicos/sangre , Índice de Masa Corporal , Caprilatos/sangreRESUMEN
BACKGROUND: Numerous reports indicate that both obesity and type 2 diabetes mellitus (T2DM) are factors associated with cognitive impairment (CI). The objective was to assess the relationship between abdominal obesity as measured by waist-to-hip ratio adjusted for body mass index (WHRadjBMI) and CI in middle-aged and elderly patients with T2DM. METHODS: A cross-sectional study was conducted, in which a total of 1154 patients with T2DM aged ≥ 40 years were included. WHRadjBMI was calculated based on anthropometric measurements and CI was assessed utilizing the Montreal Cognitive Assessment (MoCA). Participants were divided into CI group (n = 509) and normal cognition group (n = 645). Correlation analysis and binary logistic regression were used to explore the relationship between obesity-related indicators including WHRadjBMI, BMI as well as waist circumference (WC) and CI. Meanwhile, the predictive power of these indicators for CI was estimated by receiver operating characteristic (ROC) curves. RESULTS: WHRadjBMI was positively correlated with MoCA scores, independent of sex. The Area Under the Curve (AUC) for WHRadjBMI, BMI and WC were 0.639, 0.521 and 0.533 respectively, and WHRadjBMI had the highest predictive power for CI. Whether or not covariates were adjusted, one-SD increase in WHRadjBMI was significantly related to an increased risk of CI with an adjusted OR of 1.451 (95% CI: 1.261-1.671). After multivariate adjustment, the risk of CI increased with rising WHRadjBMI quartiles (Q4 vs. Q1 OR: 2.980, 95%CI: 2.032-4.371, P for trend < 0.001). CONCLUSIONS: Our study illustrated that higher WHRadjBMI is likely to be associated with an increased risk of CI among patients with T2DM. These findings support the detrimental effects of excess visceral fat accumulation on cognitive function in middle-aged and elderly T2DM patients.
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Índice de Masa Corporal , Disfunción Cognitiva , Diabetes Mellitus Tipo 2 , Relación Cintura-Cadera , Humanos , Estudios Transversales , Diabetes Mellitus Tipo 2/complicaciones , Masculino , Femenino , Persona de Mediana Edad , Anciano , Disfunción Cognitiva/etiología , Disfunción Cognitiva/epidemiología , Obesidad Abdominal/epidemiología , Obesidad Abdominal/complicaciones , Factores de Riesgo , Adulto , China/epidemiologíaRESUMEN
AIMS: The impact of life-course different adiposity indices on diabetes mellitus (DM) is poorly understood. We aimed to do trajectory analysis with repeated measurements of adiposity indices in the development of DM among women across the lifespan. METHODS: This study prospectively investigated the 1,681 population of Tehran Lipid and Glucose Study. At baseline, all individuals were free of diabetes. Trajectory analysis was used to identify homogeneous distinct clusters of adiposity indices trajectories and assign individuals to unique clusters. RESULTS: Of the 1681 healthy women, 320 progressed to the DM. Three distinct body mass index (BMI) trajectories and 2 distinct trajectories of other adiposity indices (waist circumstance (WC), conicity index (C-index), and body roundness index (BRI)) were chosen as the best fitting of the latent class growth mixture model. In the adjusted model, total participants [HR (CI 95%): 2.83 (2.05, 3.91); p < 0.001], and menopause [1.35 (1.10, 2.11); p = 0.001] and reproductive-age women [2.93 (1.80, 4.78); p = 0.003] of the high BMI trajectory compared to the ones in the low trajectory of BMI were more likely to develop DM. The high BRI in menopause had a significantly higher risk of DM compared to the low trajectory. In menopause (1.80 (1.26, 2.58)) and reproductive-age women (4.32 (2.49, 7.47)) with high trajectory of C-index, the DM risk decreased after adjustment. CONCLUSIONS: The risk of DM was greater for high BMI, WC, C-index, and BRI trajectories than for lower trajectories. Hence, the development of general, abdominal, and visceral obesity trajectories in the prevention of DM should be considered by clinicians.
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Adiposidad , Índice de Masa Corporal , Humanos , Femenino , Adiposidad/fisiología , Adulto , Persona de Mediana Edad , Irán/epidemiología , Estudios Prospectivos , Factores de Riesgo , Anciano , Diabetes Mellitus/epidemiologíaRESUMEN
BACKGROUND: Insulin resistance (IR) is prevalent in individuals undergoing peritoneal dialysis (PD) and is related to increased susceptibility to coronary artery disease and initial peritonitis. In recent investigations, correlations have been found between indices of IR and the incidence of all-cause mortality in various populations. However, such correlations have not been detected among individuals undergoing PD. Hence, the present study's aim was to explore the connections between IR indices and the incidence of all-cause mortality in PD patients. METHODS: Peritoneal dialysis patients (n = 1736) were recruited from multiple PD centres between January 2010 and December 2021. Cox proportional hazards and restricted cubic spline regression models were used to evaluate the connections between the triglyceride-glucose (TyG) index, triglyceride-glucose/body mass index (TyG-BMI), and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio and the occurrence of all-cause mortality. All three IR indices were integrated into the same model to assess the predictive stability. Furthermore, a forest plot was employed to display the findings of the subgroup analysis of PD patients. RESULTS: Overall, 378 mortality events were recorded during a median follow-up time of 2098 days. Among PD patients, a higher TyG index, TyG-BMI, and TG/HDL-C ratio were identified as independent risk factors for all-cause mortality according to Cox proportional hazards analyses (hazard ratio (HR) 1.588, 95% confidence interval (CI) 1.261-2.000; HR 1.428, 95% CI 1.067-1.910; HR 1.431, 95% CI 1.105-1.853, respectively). In a model integrating the three IR indices, the TyG index showed the highest predictive stability. According to the forest plot for the TyG index, no significant interactions were observed among the subgroups. CONCLUSION: Significant associations were found between the TyG index, TyG-BMI, and TG/HDL-C ratio and the incidence of all-cause mortality among PD patients. The TyG index may be the most stable of the three surrogate IR markers. Finally, a correlation was identified between IR and the risk of all-cause mortality in patients undergoing PD.
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Índice de Masa Corporal , Resistencia a la Insulina , Diálisis Peritoneal , Triglicéridos , Humanos , Diálisis Peritoneal/mortalidad , Masculino , Femenino , Persona de Mediana Edad , Triglicéridos/sangre , Factores de Riesgo , Modelos de Riesgos Proporcionales , Anciano , Glucemia , HDL-Colesterol/sangre , AdultoRESUMEN
This retrospective cohort study aimed to investigate the association between alcohol consumption and the onset of type 2 diabetes in middle-aged Japanese individuals. Participants were aged 40 and above from Panasonic Corporation, Osaka, Japan's medical health checkup program from 2008 to 2021. Alcohol consumption was calculated by converting the quantity consumed into daily ethanol consumption. We assessed the association between alcohol consumption and the onset of type 2 diabetes using Cox regression analysis. The total and median follow-up duration was 13 years and 7 (3-13) years (748,090 person-years). Among 102,802 participants, 7,510 participants (7.3%) developed type 2 diabetes during the study period. Alcohol consumption at the level of 0 < to < 22 g/day and 22 to < 39 g/day were negatively associated with developing type 2 diabetes compared to complete alcohol abstainers. Alcohol consumption at levels of 39 to < 66 g/day and at levels of ≥ 66 g/day were positively associated with developing type 2 diabetes in participants with BMI < 25 kg/m2. All levels of alcohol consumption were negatively associated with developing type 2 diabetes in participants with BMI ≥ 25 kg/m2. Moderate-to-heavy alcohol consumption were positively associated with developing type 2 diabetes for participants with BMI < 25 kg/m2, whereas alcohol intake was negatively associated with developing type 2 diabetes among participants with BMI ≥ 25 kg/m2.
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Consumo de Bebidas Alcohólicas , Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/etiología , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Masculino , Persona de Mediana Edad , Femenino , Japón/epidemiología , Incidencia , Estudios Retrospectivos , Adulto , Factores de Riesgo , Índice de Masa Corporal , Anciano , Pueblos del Este de AsiaRESUMEN
BACKGROUND: Sex disparity between metabolic-obesity (defined by body mass index, BMI) phenotypes and obesity-related cancer (ORC) remains unknown. Considering BMI reflecting overall obesity but not fat distribution, we aimed to systematically assess the association of our newly proposed metabolic-anthropometric phenotypes with risk of overall and site-specific ORC by sex. METHODS: A total of 141,579 men (mean age: 56.37 years, mean follow-up time: 12.04 years) and 131,047 women (mean age: 56.22 years, mean follow up time: 11.82 years) from the UK Biobank was included, and designated as metabolic-anthropometric phenotypes based on metabolic status (metabolically healthy/unhealthy), BMI (non-obesity/obesity) and body shape (pear/slim/apple/wide). The sex-specific association of different phenotypes with overall and site-specific ORC was assessed by hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression models. RESULTS: We found metabolically unhealthy and/or obesity phenotypes conveyed a higher risk in men than in women for overall ORC and colorectal cancer compared with metabolically healthy non-obesity phenotype (Pinteraction < 0.05). Of note, metabolically healthy obesity phenotype contributed to increased risks of most ORC in men (HRs: 1.58 ~ 2.91), but only correlated with higher risks of endometrial (HR = 1.89, 95% CI: 1.54-2.32) and postmenopausal breast cancers (HR = 1.17, 95% CI: 1.05-1.31) in women. Similarly, even under metabolically healthy, men carrying apple and wide shapes phenotypes (metabolically healthy apple/wide and metabolically healthy non-obesity apple/wide) suffered an increased risk of ORC (mainly colorectal, liver, gastric cardia, and renal cancers, HRs: 1.20 ~ 3.81) in comparison with pear shape or non-obesity pear shape. CONCLUSIONS: There was a significant sex disparity between metabolic-anthropometric phenotypes and ORC risk. We advised future ORC prevention and control worth taking body shape and sex disparity into account.
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Neoplasias , Obesidad , Fenotipo , Humanos , Masculino , Femenino , Persona de Mediana Edad , Obesidad/epidemiología , Obesidad/complicaciones , Estudios Prospectivos , Neoplasias/epidemiología , Índice de Masa Corporal , Anciano , Reino Unido/epidemiología , Factores Sexuales , Factores de Riesgo , Antropometría , AdultoRESUMEN
OBJECTIVES: To compare the pre-competition nutrition practices of Lithuanian elite international-level (IL) and national-level (NL) bodybuilders. METHODS: Sixteen male bodybuilders (n=8 per group) were enrolled. The IL group comprised individuals achieving 1st to 4th place in the World and European Championships organized by the IFBB, whereas the NL group ranked between 1st and 6th place in the national championships. Body mass and diet data were obtained via a questionnaire. A repeated-measures ANOVA was performed using time as a within factor and group as a between factor. RESULTS: Both groups experienced a reduction in body mass during the pre-competition phase (p<0.001), which was slower in the IL than in the NL group (p=0.048). Both groups exhibited a reduction in caloric (p<0.001), carbohydrate (p<0.001), and fat (p=0.006) intake relative to body mass, but not in protein intake. Nevertheless, the IL group had a higher intake of calories (p=0.015), protein (p<0.001), but not carbohydrates relative to body mass vs. the NL group. CONCLUSIONS: The Lithuanian IL and NL bodybuilders both reduced calories by cutting fat and carbohydrates during pre-competition. The IL group maintained higher calorie and protein intake, resulting in similar body mass loss but at a slower rate than the NL group.
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Levantamiento de Peso , Humanos , Masculino , Lituania , Adulto , Levantamiento de Peso/fisiología , Adulto Joven , Ingestión de Energía/fisiología , Dieta/estadística & datos numéricos , Atletas , Índice de Masa CorporalRESUMEN
OBJECTIVE: To examine the relationship between C-reactive protein (CRP) and knee pain, and further explore whether this association is mediated by obesity. METHODS: The population was derived from 1999 to 2004 National Health and Nutrition Examination Survey. Logistic regression was used to analyze the relationship between CRP and knee pain in three different models, and the linear trend was analyzed. A restricted cubic spline model to assess the nonlinear dose-response relationship between CRP and knee pain. Mediation analyses were used to assess the potential mediating role of obesity. Subgroup analyses and sensitivity analyses were performed to ensure robustness. RESULTS: Compared with adults with lower CRP (first quartile), those with higher CRP had higher risks of knee pain (odds ratio 1.39, 95% confidence interval 1.12-1.72 in third quartile; 1.56, 1.25-1.95 in fourth quartile) after adjusting for covariates (except body mass index [BMI]), and the proportion mediated by BMI was 76.10% (p < .001). BMI and CRP were linear dose-response correlated with knee pain. The odds ratio for those with obesity compared with normal to knee pain was 2.27 (1.42-3.65) in the first quartile of CRP, 1.99 (1.38-2.86) in the second, 2.15 (1.38-3.33) in the third, and 2.92 (1.72-4.97) in the fourth. CONCLUSION: Obesity mediated the systemic inflammation results in knee pain in US adults. Moreover, higher BMI was associated with higher knee pain risk in different degree CRP subgroups, supporting an important role of weight loss in reducing knee pain caused by systemic inflammation.
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Índice de Masa Corporal , Proteína C-Reactiva , Encuestas Nutricionales , Obesidad , Humanos , Obesidad/sangre , Obesidad/epidemiología , Obesidad/complicaciones , Proteína C-Reactiva/análisis , Proteína C-Reactiva/metabolismo , Masculino , Femenino , Estudios Transversales , Persona de Mediana Edad , Adulto , Articulación de la Rodilla , Dolor/epidemiología , Dolor/sangre , Dolor/etiología , Artralgia/sangre , Artralgia/epidemiología , Artralgia/etiología , Anciano , Factores de Riesgo , Oportunidad RelativaRESUMEN
Background: The relationship between atherogenic index of plasma (AIP) and triglyceride glucose-body mass index (TyG-BMI) and sarcopenia has not been studied in the United States (US) population. Methods: This research included 4,835 people from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2018. The relationship between sarcopenia and TyG-BMI, as well as the AIP index, was examined through the utilization of restricted cubic spline (RCS) analysis, subgroup analysis, and multivariate logistic regression analysis. Diagnostic value of AIP and TyG-BMI for sarcopenia was compared by receiver operating characteristic (ROC) curves. Results: In this research, 428 people with sarcopenia were identified among the 4,835 subjects that were included in the experiment. AIP and sarcopenia were positively associated with an odds ratio (OR) of 1.58 and a 95% confidence interval (CI) of (1.07, 2.34) on fully adjusted multivariate logistic regression analysis. Similarly, TyG-BMI and sarcopenia were positively associated with an OR of 8.83 and a 95% CI of (5.46, 14.26). AIP and sarcopenia had a non-linear positive connection (P-value<0.001, P-Nonlinear=0.010), while TyG-BMI and sarcopenia had a linear positive correlation (P-value<0.001, P-Nonlinear=0.064), according to RCS analysis. Subgroup analyses showed a significant interaction between TyG-BMI and sarcopenia due to gender (P = 0.023). ROC curves showed that TyG-BMI (AUC:0.738, 95% CI: 0.714 - 0.761) was more useful than AIP (AUC:0.648, 95% CI: 0.622 - 0.673) in diagnosing sarcopenia. Conclusion: In US adults aged 20-59 years, our study revealed a correlation between elevated AIP and TyG-BMI levels and heightened sarcopenia risk. Moreover, TyG-BMI has better diagnostic validity than AIP.
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Aterosclerosis , Glucemia , Índice de Masa Corporal , Sarcopenia , Triglicéridos , Humanos , Sarcopenia/sangre , Sarcopenia/diagnóstico , Sarcopenia/epidemiología , Femenino , Masculino , Estudios Transversales , Persona de Mediana Edad , Adulto , Triglicéridos/sangre , Glucemia/análisis , Aterosclerosis/sangre , Aterosclerosis/diagnóstico , Aterosclerosis/epidemiología , Adulto Joven , Encuestas NutricionalesRESUMEN
Background: This cross-sectional study aimed to address a critical gap in the understanding of the association between body mass index (BMI) and physical fitness levels in adolescents with hearing impairment (HI) in China. This study investigated how different BMI levels impact the physical fitness index (PFI) of HI adolescents. Methods: This study employed a physical fitness test for HI adolescents attending special education schools. The test included eight components: height, weight, 50-m sprint, standing long jump, sit and reach, endurance run, bent-knee sit-up (for girls), and pull-up (for boys). Test scores for each student were standardized by age and gender. Individual Z-scores were then calculated, and the sum of these Z-scores constituted the PFI. Logistic regression was used to analyze the relationship between BMI and PFI across different gender and age groups. Statistical significance was set at P < 0.05. Results: The linear regression model showed an inverted U-shaped relationship between BMI and PFI. At the same BMI level, boys exhibited superior physical fitness compared to girls with the same BMI (P < 0.05). Statistically significant differences in PFI levels were observed between normal-weight and obese males, as well as between underweight and obese boys (P < 0.05). In the 13-15 and 16-18 age groups, the increase in BMI has a greater impact on boys PFI than on girls. Conclusions: Adolescents with HI generally demonstrated good physical fitness. Compared to individuals with normal weight, those who were underweight, overweight, or obese exhibited lower levels of physical fitness. Future interventions should focus on adolescents with HI with abnormal BMI.