ABSTRACT
Background: The prevalence of obesity is increasing worldwide. Obesity is associated with severe health effects. Abdominal obesity has a strong association with metabolic dysfunction. A subgroup of people with central obesity has been identified without typical metabolic disorders associated with obesity that has been known metabolically healthy abdominal obese (MHAO). The purpose of this review is to evaluate the MHAO phenotype in the context of type 2 DM incidence, risk of cardiovascular diseases, and all-cause of mortality. Methods: This is a protocol of systematic review. We will search PubMed/MEDLINE, EMBASE, Web of Science, Cochrane Library, and ProQuest. Additional studies will be identified through manual searching of reference lists. Quantitative studies evaluating abdominal obesity phenotype outcomes in adults will be included. Primary results will be assaying abdominal obesity phenotype results, including DM2 incidence, cardiovascular disease risk, and all-cause mortality. Two reviewers will independently screen full-text articles and abstract data. Statistical Analysis Used: Potential conflicts will be resolved through discussion. Results: The study methodological quality (or bias) will be appraised using appropriate tools. If feasible, we will conduct a random-effects meta-analysis. The researchers will also assess the quality of the articles independently based on Newcastle-Ottawa scale. Conclusions: The results of this review will provide a useful reference for the effect of abdominal obesity on metabolic dysfunction and cardiovascular or all-cause mortality.
ABSTRACT
BACKGROUND: Congenital hypothyroidism (CH) is an important and preventable cause of intellectual disability. This study determined the incidence of CH and its related factors in Semnan city in Iran. METHODS: All neonates born in Semnan from 2011 to 2016 who participated in a screening program for CH were evaluated to estimate the incidence of CH. In a nested case-control study, all diagnosed CH cases were compared with a control group of healthy newborns. Statistical analysis used conditional logistic regression model with STATA-14. RESULTS: 106 out of 17,507 neonates born in Semnan during 2011-2016 were diagnosed with CH (6.05 cases per 1,000 live births). Maternal parity (odds ratio [OR] =1.78, P = 0.044), birth weight (OR = 0.29, P = 0.001), parental history of thyroid disease (OR = 3.43, P = 0.001), father's education (OR = 0.71, P = 0.003), father's occupation (nonworker) (OR = 2.97, P = 0.001), and the presence of other anomalies (OR = 4.14, P = 0.037) were related to the incidence of CH. CONCLUSIONS: The cumulative incidence of CH in Semnan was higher than in both the global and national statistics. Aside from well-known medical determinants, some important social factors such as father's occupation and education have a significant and independent relationship with occurrence of CH; rational attention should be given to them in health care programs to increase the effectiveness of preventative measures for CH.
ABSTRACT
OBJECTIVE: Obesity is a heterogeneous condition and risk of related health outcomes in different obesity phenotypes is a controversial subject. In this study, we aimed to evaluate the risk of cardiovascular disease (CVD) in different abdominal obesity phenotypes during a decade-long follow-up. METHODS: In this large population-based cohort, 7122 participants (42.7% men), aged ≥30 years, from the Tehran Lipid and Glucose Study (TLGS) were enrolled. Abdominal obesity was defined using national waist circumference cut-off points of ≥89 cm for men and ≥91 cm for women. Metabolic health was defined as ≤1 components of metabolic syndrome (excluding waist circumference), using the Joint Interim Statement (JIS) definition. RESULTS: At baseline, 3745 individuals (52.7%) were abdominal obese and 23.5% (n = 881) of these were categorized as "metabolically healthy abdominal obese" (MHAO). A total of 638 CVD events occurred during a median follow-up of 10 years (1999-2011). "Metabolically healthy non-abdominal obese" was considered as the reference group. After adjustment for various variables, MHAO individuals were at increased risk for CVD events compared with the reference group (HR: 1.64, CI: 1.09-2.47). Both the metabolically unhealthy phenotypes (with and without abdominal obesity) were also at increased risk. We also observed the same pattern using insulin resistance data for categorizing abdominal obesity phenotypes. CONCLUSION: Abdominal obesity and presence of metabolic derangements are both important risk factors for future CVD. MHAO may not be a benign condition regarding future CVD events, which highlights the importance of prevention and treatment of abdominal obesity, even in the absence of metabolic derangements.
