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Deutsches Arzteblatt International Sep 2020
Topics: Body Mass Index; Humans; Obesity; Waist-Hip Ratio
PubMed: 33357347
DOI: 10.3238/arztebl.2020.0659a -
BMJ (Clinical Research Ed.) Sep 2020To quantify the association of indices of central obesity, including waist circumference, hip circumference, thigh circumference, waist-to-hip ratio, waist-to-height... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To quantify the association of indices of central obesity, including waist circumference, hip circumference, thigh circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, with the risk of all cause mortality in the general population, and to clarify the shape of the dose-response relations.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
PubMed and Scopus from inception to July 2019, and the reference lists of all related articles and reviews.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Prospective cohort studies reporting the risk estimates of all cause mortality across at least three categories of indices of central fatness. Studies that reported continuous estimation of the associations were also included.
DATA SYNTHESIS
A random effects dose-response meta-analysis was conducted to assess linear trend estimations. A one stage linear mixed effects meta-analysis was used for estimating dose-response curves.
RESULTS
Of 98 745 studies screened, 1950 full texts were fully reviewed for eligibility. The final analyses consisted of 72 prospective cohort studies with 2 528 297 participants. The summary hazard ratios were as follows: waist circumference (10 cm, 3.94 inch increase): 1.11 (95% confidence interval 1.08 to 1.13, I=88%, n=50); hip circumference (10 cm, 3.94 inch increase): 0.90 (0.81 to 0.99, I=95%, n=9); thigh circumference (5 cm, 1.97 inch increase): 0.82 (0.75 to 0.89, I=54%, n=3); waist-to-hip ratio (0.1 unit increase): 1.20 (1.15 to 1.25, I=90%, n=31); waist-to-height ratio (0.1 unit increase): 1.24 (1.12 to 1.36, I=94%, n=11); waist-to-thigh ratio (0.1 unit increase): 1.21 (1.03 to 1.39, I=97%, n=2); body adiposity index (10% increase): 1.17 (1.00 to 1.33, I=75%, n=4); and A body shape index (0.005 unit increase): 1.15 (1.10 to 1.20, I=87%, n=9). Positive associations persisted after accounting for body mass index. A nearly J shaped association was found between waist circumference and waist-to-height ratio and the risk of all cause mortality in men and women. A positive monotonic association was observed for waist-to-hip ratio and A body shape index. The association was U shaped for body adiposity index.
CONCLUSIONS
Indices of central fatness including waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, independent of overall adiposity, were positively and significantly associated with a higher all cause mortality risk. Larger hip circumference and thigh circumference were associated with a lower risk. The results suggest that measures of central adiposity could be used with body mass index as a supplementary approach to determine the risk of premature death.
Topics: Body Mass Index; Humans; Obesity, Abdominal; Waist Circumference; Waist-Hip Ratio
PubMed: 32967840
DOI: 10.1136/bmj.m3324 -
Waist-hip ratio as a predictor of myocardial infarction risk: A systematic review and meta-analysis.Medicine Jul 2018Several studies have identified that obesity and being overweight can increase the risk of developing myocardial infarction (MI). However, the predictive value of the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIM
Several studies have identified that obesity and being overweight can increase the risk of developing myocardial infarction (MI). However, the predictive value of the central obesity index, that is, the waist-hip ratio (WHR), regarding MI risk remains unclear. This study aimed to provide a systematic review and meta-analysis of WHR as a predictor of MI incidence.
METHODS
This study used relevant keywords and MeSH terms to identify studies of MI risk and WHR from PubMed, Web of Science, Embase, and Cochrane databases in November 2017.
RESULTS
We conducted a meta-analysis of 12 case-control studies in 14 eligible trials and further explored whether the predictive value of WHR on MI risk varies according to sex. The results showed that a high WHR increased MI risk (pooled odds ratio [OR] 2.62, 95% confidence interval [CI] 2.02-3.39, P < 0.00001) and that elevated WHR is more strongly predictive of MI in women than in men (pooled OR 4.63, 95% CI 3.28-6.53 in women; pooled OR 2.71, 95% CI 2.15-3.41 in men).
CONCLUSIONS
MI is significantly associated with increased WHR, with a stronger association among women.
Topics: Comorbidity; Female; Humans; Male; Myocardial Infarction; Obesity, Abdominal; Risk Factors; Sex Distribution; Waist-Hip Ratio
PubMed: 30045310
DOI: 10.1097/MD.0000000000011639 -
Frontiers in Endocrinology 2022Although studies have shown that higher waist-hip ratio (WHR) is closely related to higher risk of metabolism-related diseases, the relationship between WHR and...
BACKGROUND
Although studies have shown that higher waist-hip ratio (WHR) is closely related to higher risk of metabolism-related diseases, the relationship between WHR and subclinical myocardial injury (SC-MI) is unknown. This study was to evaluate the effect of WHR on SC-MI in the general population free from cardiovascular disease.
METHODS
The cross-sectional study included 6253 participants without cardiovascular disease (CVD) from the third National Health and Nutrition Examination Survey (NHANES III) for further analysis. Restricted cubic spline, multivariable logistic regression models and subgroup analyses were performed to assess the association between WHR and SC-MI.
RESULTS
The multivariate logistic regression showed that after adjusting for potential confounding factors, participants in the higher quartiles had higher risk of developing SC-MI than those in the first quartile of WHR [Q3, OR (95% CI): 1.523 (1.159, 2.000), P = 0.002; Q4, OR (95% CI): 1.719 (1.279, 2.311), P < 0.001], and this relationship was robust among the participants aged ≥ 50 years, with hypertension and without diabetes. Every 0.1 unit increase in WHR, as a continuous variable, increased the risk of SC-MI by more than 20% [OR (95% CI): 1.233 (1.092, 1.392), P = 0.001]. And restricted cubic spline analysis showed that there was a linear positive correlation between WHR and the risk of SC-MI.
CONCLUSIONS
WHR may be an independent risk factor for SC-MI in the general population free from CVD.
Topics: Cardiovascular Diseases; Cross-Sectional Studies; Humans; Nutrition Surveys; Risk Factors; Waist-Hip Ratio
PubMed: 36213276
DOI: 10.3389/fendo.2022.975327 -
Frontiers in Endocrinology 2023It is suggested that body mass index (BMI) can affect male semen quality; however, the results remain controversial. In addition, most studies have focused on the effect...
BACKGROUND
It is suggested that body mass index (BMI) can affect male semen quality; however, the results remain controversial. In addition, most studies have focused on the effect of obesity on semen quality. Evidence on the relationship of underweight or waist-hip ratio (WHR) with semen quality is rare. This study aimed to assess the association of BMI and WHR with semen quality.
METHODS
Data, including BMI and WHR, was collected from 715.00 men who underwent a fertility evaluation. BMI (kg/m) was categorized as <18.50 (underweight), 18.50-24.90 (normal), 25.00-27.90 (overweight), and ≥28.00 (obese) kg/m for analysis. WHR was categorized as <0.81 (normal) and ≥0.81 (high). Semen volume, sperm concentration, progressive motility, and total motile sperm count were detected by experienced clinical technicians.
RESULTS
Spearman's correlation showed that BMI was weakly associated with sperm progressive motility (r = 0.076, < 0.05), while WHR showed no relationship with semen parameters. The azoospermia rate was significantly higher (33.33% vs. 2.10%, < 0.001) and the sperm concentration was lower ( < 0.05) in the underweight group. The nonlinear correlation analysis showed that BMI was negatively associated with sperm concentration while BMI was more than 22.40 kg/m ( < 0.05), while WHR was negatively related to sperm progressive motility within 0.82 to 0.89 ( < 0.05). Furthermore, the multivariate logistic analysis showed that follicular stimulating hormone (FSH) was an independent risk factor for normal sperm concentration (odds ratio [OR]: 0.791, = 0.001) and morphology (OR: 0.821, = 0.002), BMI was an independent risk factor for normal sperm progressive motility, and testosterone was an independent risk factor for sperm morphology (OR: 0.908, = 0.023).
CONCLUSION
BMI and WHR were significantly associated with semen parameters, while BMI was an independent risk factor for normal sperm progressive motility. Reproductive hormones, including FSH and testosterone, had a significant influence on sperm concentration and sperm morphology.
Topics: Humans; Male; Semen; Semen Analysis; Body Mass Index; Retrospective Studies; Waist-Hip Ratio; Infertility, Male; Thinness; Obesity; Follicle Stimulating Hormone; Testosterone
PubMed: 37455907
DOI: 10.3389/fendo.2023.1148715 -
Obesity Facts 2020Waist-to-hip ratio (WHR) is a strong predictor of mortality in patients with heart failure (HF). However, common WHR trajectories are not well established in HF with...
BACKGROUND
Waist-to-hip ratio (WHR) is a strong predictor of mortality in patients with heart failure (HF). However, common WHR trajectories are not well established in HF with mid-range ejection fraction (HFmrEF) persons, and their relationship to clinical outcomes remains uncertain.
METHOD
We prospectively enrolled 1,396 participants with HFmrEF (left ventricular ejection fraction 40-49%) from April 2013 through April 2017. The waist and hip circumferences of the subjects were measured at regular intervals, and the WHR was calculated as waist circumference divided by hip circumference. Latent mixture modeling was performed to identify WHR trajectories. We then used Cox proportional-hazard models to examine the association between WHR trajectory patterns and incident HF, incident cardiovascular disease (CVD), and all-cause mortality.
RESULTS
We identified four distinct WHR trajectory patterns: lean-moderate increase (9.2%), medium-stable/increase (32.7%), heavy-stable/increase (48.0%), and heavy-moderate decrease (10.1%). After multivariable adjustment, the heavy-stable/increase and heavy-moderate decrease patterns were associated with an increased all-cause mortality risk (heavy-stable/increase: adjusted hazard ratio [HR] 3.18, 95% confidence interval [CI] 2.75-4.62; heavy-moderate decrease: adjusted HR 2.32, 95% CI 1.71-3.04), incident CVD risk (heavy-stable/increase: adjusted HR 4.03, 95% CI 2.39-4.91; heavy-moderate decrease: adjusted HR 3.05, 95% CI 2.34-4.09), and incident HF risk (heavy-stable/increase: adjusted HR 2.72, 95% CI 2.05-3.28; heavy-moderate decrease: adjusted HR 2.39, 95% CI 1.80-3.03) with reference to the lean-moderate increase pattern.
CONCLUSION
Among patients with HFmrEF, the trajectories of WHR gain are associated with poor outcomes. These findings highlight the importance of abdominal fat accumulation management during the progression of HFmrEF.
Topics: Cause of Death; Heart Failure; Humans; Prognosis; Risk Factors; Ventricular Function, Left; Waist-Hip Ratio
PubMed: 32570251
DOI: 10.1159/000507708 -
International Journal of Environmental... Sep 2022Obesity is a prevalent health issue. Evidence suggests that the availability of urban nature may reduce the risks of obesity. However, several knowledge gaps remain....
Obesity is a prevalent health issue. Evidence suggests that the availability of urban nature may reduce the risks of obesity. However, several knowledge gaps remain. This study explores the relationships between the dose (distance, duration and frequency) of urban nature and demographic factors towards obesity risks among people in Thailand. A total of 111 participants in three urban and peri-urban nature locations answered a survey regarding their distance from green spaces, frequency of visits, and duration of their typical stay, as well as their socio-demographics, and waist-hip ratio (WHR). The results suggested that at least 1-2 h per typical visit to nature predicted low-risk WHR in women. Male participants are more likely to have a high-risk WHR. Increasing age predicted low-risk WHR. Spending more time in green spaces predicted lower odds of high-risk WHR, while distance did not predict the odds. This research is one of the first to study the relationship between time spent in nature and obesity, and one of the first nature and health studies conducted in Thailand. Given that Thailand is one of the countries most affected by obesity in Southeast Asia, this study is relevant and essential. Future research should explore the quality factors of the park with longer duration of stay.
Topics: Body Mass Index; Female; Humans; Male; Obesity; Risk; Risk Factors; Thailand; Waist-Hip Ratio
PubMed: 36141879
DOI: 10.3390/ijerph191811606 -
Menopause (New York, N.Y.) Sep 2020Many studies have reported that body composition might be associated with cardiovascular disease, but the issue has not been fully investigated in postmenopausal women.
OBJECTIVE
Many studies have reported that body composition might be associated with cardiovascular disease, but the issue has not been fully investigated in postmenopausal women.
METHODS
This retrospective study comprised 582 postmenopausal women without a history of cardiovascular disease who visited the Health Promotion Center between May 2008 and February 2018. All women were screened for body fat composition by bioelectrical impedance analysis and for degree of coronary artery calcification (CAC) by multidetector computed tomography. In addition, multivariate analysis, integrated discrimination improvement, and category-free net reclassification improvement were performed.
RESULTS
The level of triglycerides, and the waist-hip ratio (WHR) in participants with CAC (coronary artery calcium score [CACS] > 0) were higher than in participants with a CACS of zero points. When the participants were stratified into four groups according to WHR, participants with CAC (CACS > 0) increased significantly as WHR quartile increased. A multivariate analysis showed that older age (odds ratio [OR]: 2.539; 95% confidence interval [CI]: 1.524-4.230; P < 0.001), triglyceride level (OR: 1.005; 95% CI: 1.002-1.008; P = 0.003), WHR (OR: 1.103; 95% CI: 1.018-1.195; P = 0.017), and history of hypertension (OR: 2.701; 95% CI: 1.715-4.253; P < 0.001) were significantly associated with CAC. The Brier score upon adding WHR to a clinical model was lower than that of the clinical model without WHR. Adding WHR to a clinical model better predicted CAC than a clinical model without WHR (C index: 0.761, 95% CI: 0.724-0.795, P < 0.001; net reclassification improvement: 0.195, P = 0.037; integrated discrimination improvement: 1.02%, P = 0.043).
CONCLUSIONS
In asymptomatic postmenopausal women, WHR as measured by bioelectrical impedance analysis was significantly associated with coronary atherosclerosis, supplementing information of usual clinical markers. Hence, WHR might be appropriate as a marker for early atherosclerosis.
Topics: Aged; Coronary Artery Disease; Female; Humans; Postmenopause; Retrospective Studies; Risk Factors; Vascular Calcification; Waist-Hip Ratio
PubMed: 32852452
DOI: 10.1097/GME.0000000000001581 -
BMC Cancer Jul 2021Body weight management was an important component in breast cancer survivorship care. The present study described the change patterns of body weight and waist-to-hip...
BACKGROUND
Body weight management was an important component in breast cancer survivorship care. The present study described the change patterns of body weight and waist-to-hip ratio (WHR) during the first 5 years of survival, and investigated potential factors associated with very substantial changes.
PATIENTS AND METHODS
Based on a longitudinal cohort with 1462 Chinese women with breast cancer, anthropometric measurements including body weight, height, waist and hip circumferences were measured by trained interviewers following standard protocol at four time-points: baseline at study entry, 18-, 36- and 60-months follow up assessments (termed as T0, T1, T2 and T3, respectively). Body height was measured at baseline and body weight at cancer diagnosis were retrieved from medical record.
RESULTS
Compared to weight at breast cancer diagnosis, the median weight change was - 0.5 kg, 0 kg, + 0.5 kg, and + 1 kg at T0, T1, T2 and T3, respectively. During the first 5 years of survival, the proportion of women who were obese have slightly increased. At 60-months after diagnosis, only 14.3% of women had weight gain by > 5 kg; and the percentage of women who had weight gain by > 10% was 10.7%. Nearly half of patients had abdominal obesity at study entry, and this proportion were gradually increased to nearly 70% at 60-months follow-up. Multivariate analysis indicated that older age, and frequent sports participation during the first 5 years of survival were related to lower risk of very substantial weight gain (> 10%) at 60-month follow-up; patients aged 40-49 years, having ≥2 comorbidities and ER negative were associated with less likelihood of very substantial WHR substantial increase (> 10%) at 60-month follow-up.
CONCLUSION
Weight gain was modest in Chinese breast cancer survivors during the first 5 years of survival, while central adiposity has become a contemporary public health issue. The incorporation of healthy weight and abdominal circumference patient education and management has a potential to improve cancer survivorship.
Topics: Body Mass Index; Body Weight Maintenance; Breast Neoplasms; Female; Humans; Longitudinal Studies; Middle Aged; Survival Analysis; Time Factors; Waist-Hip Ratio
PubMed: 34284751
DOI: 10.1186/s12885-021-08554-5 -
Nutricion Hospitalaria Aug 2020Background: the goal of this study was to define waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHRt) smoothed reference percentiles for...
Background: the goal of this study was to define waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHRt) smoothed reference percentiles for assessing abdominal obesity in Macedonian adolescents aged 11 to 18 years in order to investigate possible obesity cut-offs of WHR and WHtR, and to compare WC percentiles with those of other adolescents. Methods: the research was conducted on a sample of 2,490 adolescents of the Republic of Macedonia aged 11 to 18 years: 1,288 males and 1,202 females. Weight, height, body mass index (BMI), WC, hip circumference (HC), WHR and WHtR were measured and percentiles were calculated using Cole's Lambda, Mu and Sigma (LMS) method. The relation between WHR, WHtR and general obesity, as defined by the International Obesity Task Force, was investigated with a receiver operating characteristic (ROC) analysis. Results: the boys had statistically significant higher values in all anthropometric measures except in HC, where statistically significant gender differences were not found. BMI, WC, and HC showed an increasing trend with age. The WHtR variable is a better indicator for assessing general obesity in both boys and girls (AUC, 95 % CI: 0.905-0.928) than WHR, which showed lower AUC values (95 % CI: 0.697-0.734) in predicting IOTF obesity; the WHtR cut-off of 0.5 had a sensitivity of 74 % and a specificity of 92 % for both genders and all age groups. Conclusions: the obtained reference percentile curves can be used temporarily for early detection of abdominal obesity among Macedonian adolescents aged 11 to 18 years; a WHtR of 0.5 may also be used as an obesity threshold in these age groups.
Topics: Adolescent; Child; Cross-Sectional Studies; Female; Humans; Male; Obesity, Abdominal; Pediatric Obesity; Republic of North Macedonia; Waist Circumference; Waist-Height Ratio; Waist-Hip Ratio
PubMed: 32686451
DOI: 10.20960/nh.03006