Association of weight-adjusted waist index with cardiovascular disease and mortality among metabolic syndrome population.

Metabolic syndrome (MetS) is prevalent and significantly impacts global public health, with obesity being a major risk factor for cardiovascular diseases (CVD) and mortality. Traditional metrics like body mass index (BMI) have limitations in assessing obesity-related risks. The weight-adjusted waist circumference index (WWI) has emerged as a novel obesity metric, this study aimed to evaluate the association of WWI with CVD and mortality in MetS patients. This study used data from 12,641 participants with MetS, derived from the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2020. The WWI was calculated, and its association with CVD and mortality was assessed using multivariate logistic and Cox regression models. The study controlled for potential confounders and performed subgroup and sensitivity analyses to validate the robustness of the findings. The predictive performance of WWI was evaluated using the area under the receiver operating characteristic curve (ROC). Kaplan-Meier (KM) curves further were used to evaluate the associations between WWI and mortality of the MetS population. As WWI values escalated, there was a proportional rise in the risk of CVD and mortality in MetS. The fully adjusted continuous model revealed a 32.0% elevated likelihood of CVD development, a 69.5% increased probability of heart failure (HF), a 51.1% heightened risk for CVD mortality, and a 22.8% augmented risk for all-cause mortality with each one-unit increment in WWI. Comparing the highest to the lowest quartile of WWI, the top quartile exhibited a significantly increased risk of CVD (odds ratio [OR] = 1.883; 95% confidence interval [CI]: 1.276-2.633, p-value = 0.001), HF (OR = 2.909; 95% CI: 1.490-5.677, p-value = 0.002), CVD mortality (hazard ratio [HR] = 2.088; 95% CI: 1.279-3.409, p-value = 0.003), and all-cause mortality (HR = 1.394; 95% CI: 1.070-1.816, p-value = 0.014) among individuals with MetS. Sensitivity and subgroup analyses substantiated the consistency and stability of these associations across various demographic groups. The ROC analysis demonstrated that WWI outperforms BMI in predicting adverse outcomes in MetS. The KM curves validated that higher WWI values was correlated with diminished survival rates in MetS population. The WWI served as a significant indicator for assessing the risk of CVD and mortality in the MetS population. This study recommended the regular assessment of WWI in MetS individuals for evaluating their risk of CVD and mortality, potentially enhancing preventive and treatment strategies for this patient population.

The association between weight-adjusted waist circumference index and cardiovascular disease and mortality in patients with diabetes.

Cardiovascular disease (CVD) is a significant health concern, particularly among patients with diabetes. The weight-adjusted waist circumference index (WWI), a novel metric that accounts for central obesity, has shown potential in predicting obesity-related health risks. This study aimed to evaluate the association of WWI with CVD and mortality in patients with diabetes. Utilizing data from the National Health and Nutrition Examination Survey from 1999 to 2020, WWI was calculated by dividing waist circumference (WC) by the square root of body weight. Multivariate logistic regression, multivariate Cox regression and restricted cubic spline curves were used to assess the association between WWI and the prevalence of CVD and mortality in patients with diabetes, subgroup and sensitivity analyses were carried out to delve into the stability of the findings. The predictive performance of WWI was evaluated using the area under the receiver operating characteristic curve (ROC). This study included 8,005 individuals with diabetes. With the increase in WWI values, the risk of developing CVD and the likelihood of mortality progressively rise. The fully adjusted continuous model indicated a 28% higher chance of developing CVD and a 25% higher risk of all-cause mortality for each one-unit increase in WWI. When using the lowest quartile of WWI as the reference category, the highest quartile was linked to an increased risk of CVD (OR 1.66; 95% CI 1.10-2.50, p = 0.015) and all-cause mortality (HR 1.53, 95% CI 1.27-1.83, p < 0.001) among patients with diabetes. Subgroup and sensitivity analyses confirmed that these associations were consistent and stable in most different demographics. The ROC analysis indicated that WWI had a higher predictive capacity for CVD and all-cause mortality than WC, waist to hip ratio, and weight to height ratio. The WWI was significantly associated with the prevalence of CVD and all-cause mortality among patients with diabetes in the United States and may serve as a useful tool for identifying individuals at risk.

Maternal gestational diabetes mellitus associates with altered gut microbiome composition and head circumference abnormalities in male offspring.

The impact of gestational diabetes mellitus (GDM) on maternal or infant microbiome trajectory remains poorly understood. Utilizing large-scale longitudinal fecal samples from 264 mother-baby dyads, we present the gut microbiome trajectory of the mothers throughout pregnancy and infants during the first year of life. GDM mothers had a distinct microbiome diversity and composition during the gestation period. GDM leaves fingerprints on the infant's gut microbiome, which are confounded by delivery mode. Further, Clostridium species positively correlate with a larger head circumference at month 12 in male offspring but not females. The gut microbiome of GDM mothers with male fetuses displays depleted gut-brain modules, including acetate synthesis I and degradation and glutamate synthesis II. The gut microbiome of female infants of GDM mothers has higher histamine degradation and dopamine degradation. Together, our integrative analysis indicates that GDM affects maternal and infant gut composition, which is associated with sexually dimorphic infant head growth.

Association of weight-adjusted waist index with hyperuricemia and gout among middle-aged and older adults in America: a cross-sectional analysis of NHANES 2007-2014.

OBJECTIVES: The weight-adjusted waist circumference index (WWI), a novel obesity indicator, gives better accuracy in assessing both muscle and fat mass. Our goal was to evaluate the relationship between WWI and the occurrence of hyperuricemia/gout among middle-aged and older adults in America. METHODS: We analyzed the National Health and Nutrition Examination Survey (NHANES) data from the 2007-2014 cycles. Logistic regression analyses, subgroup analyses, and restricted cubic splines (RCS) were performed to evaluate the association between WWI and hyperuricemia/gout prevalence. RESULTS: A total of 5332 adults aged 50 years and above were included in this study. The prevalence of hyperuricemia and gout was 23.20% and 6.70% respectively. The fourth quartile of WWI was associated with a 56% higher risk for hyperuricemia, compared with the first quartile (OR = 1.56, 95% CI 1.07-2.27, P trend < 0.001). A similar association was found between continuous WWI increase and OR of hyperuricemia in the fully adjusted model (OR = 1.35, 95% CI = 1.13-1.61, P < 0.05). However, WWI was not significantly associated with the prevalence of gout. The RCS model suggested a significant linear relationship between WWI and the risk of hyperuricemia/gout. Stratification analysis showed that the positive associations of WWI with the risk of hyperuricemia were more pronounced in participants who were women, aged 50-59, smokers, no physical activity, non-diabetes, hypertension, and hyperlipidemia. CONCLUSIONS: Our findings suggest a positive correlation between WWI and hyperuricemia among middle-aged and older adults in America. Employing WWI as a tool for hyperuricemia prevention may be meaningful. Key Points • Weight-adjusted waist circumference index is a new obesity evaluation index. • Weight-adjusted waist circumference index is associated with hyperuricemia not gout. • The association is more pronounced in participants who were women, aged 50-59, smokers, no physical activity, non-diabetes, hypertension, and hyperlipidemia.

Triglyceride-glucose-waist circumference index predicts the incidence of cardiovascular disease in Korean populations: competing risk analysis of an 18-year prospective study.

BACKGROUND: The triglyceride and glucose-waist circumference (TyG-WC) index demonstrated a strong association with insulin resistance, especially in Asian population. However, evidence on the association between TyG-WC index and the occurrence of cardiovascular disease (CVD) is limited. This study aimed to verify association between the TyG-WC index and the occurrence of CVD by considering all-cause mortality as a competing risk. METHODS: The study included 7482 participants divided into four groups based on the TyG-WC index quartiles. Kaplan-Meier curves illustrated cumulative incidence rates of CVD and all-cause mortality during the follow-up period. Log-rank tests determined group differences. The Cox proportional hazard spline curve demonstrates the dose-dependent relationship between the TyG-WC index and incident CVD. Modified Cox regression (Fine and Gray) estimated hazard ratios (HRs) with 95% CIs for incident CVD, treating death as a competing risk. Death event after incident CVD was excluded from the death count. RESULTS: During the median 15.94 year of follow-up period, a total of 691 (9.24%) new-onset CVD cases and 562 (7.51%) all-cause mortality cases were confirmed. Cox proportional hazard spline curves suggested that TyG-WC index exhibited a dose-dependent positive correlation with incident CVD. The cumulative incidence rate of CVD was significantly higher in the groups with higher TyG-WC index quartiles in Kaplan-Meier curves. The adjusted HR (95% CI) for incident CVD in Q2-Q4, compared with Q1, was 1.47 (1.12-1.93), 1.91 (1.44-2.54) and 2.24 (1.63-3.07), respectively. There was no significant association between TyG-WC index and all-cause mortality. Specifically, angina and stroke were significantly associated with the TyG-WC index, in contrast to myocardial infarction and peripheral artery disease. CONCLUSIONS: The TyG-WC index was positively associated with incident CVD even considering all-cause mortality as a competing risk. Therefore, TyG-WC index may be a valuable marker for predicting the occurrence of CVD.

[Relationship of triglyceride-glucose index and its derivatives with blood pressure abnormalities in adolescents: an analysis based on a restricted cubic spline model]. / åŸºäºŽé™åˆ¶æ€§ç«‹æ–¹æ ·æ¡æ¨¡åž‹åˆ†æžé’å°‘å¹´ä¸‰é °ç”˜æ²¹-è‘¡è„ç³–æŒ‡æ•°åŠå ¶è¡ç”ŸæŒ‡æ•°ä¸Žè¡€åŽ‹å¼‚å¸¸çš„å ³ç³».

OBJECTIVES: To explore the relationship of triglyceride-glucose index (TyG), triglyceride-glucose-body mass index (TyG-BMI), and triglyceride-glucose-waist circumference index (TyG-WC) with blood pressure abnormalities in adolescents, providing theoretical basis for the prevention and control of hypertension in adolescents. METHODS: A stratified cluster sampling method was used to select 1 572 adolescents aged 12 to 18 years in Yinchuan City for questionnaire surveys, physical measurements, and laboratory tests. Logistic regression analysis and restricted cubic spline analysis were employed to examine the relationship of TyG, TyG-BMI, and TyG-WC with blood pressure abnormalities in adolescents. RESULTS: Multivariable logistic regression analysis revealed that after adjusting for confounding factors, the groups with the highest quartile of TyG, TyG-BMI, and TyG-WC had 1.48 times (95%CI: 1.07-2.04), 3.71 times (95%CI: 2.67-5.15), and 4.07 times (95%CI: 2.89-5.73) higher risks of blood pressure abnormalities compared to the groups with the lowest quartile, respectively. Moreover, as the levels of TyG, TyG-BMI, and TyG-WC increased, the risk of blood pressure abnormalities gradually increased (P<0.05). A non-linear dose-response relationship was observed between TyG-BMI and the risk of blood pressure abnormalities (P overall trend<0.001, P non-linearity=0.002). Linear dose-response relationships were found between TyG and the risk of blood pressure abnormalities (P overall trend<0.001, P non-linearit =0.232), and between TyG-WC and the risk of blood pressure abnormalities (P overall trend<0.001, P non-linearity=0.224). CONCLUSIONS: Higher levels of TyG and its derivatives are associated with an increased risk of blood pressure abnormalities in adolescents, with linear or non-linear dose-response relationships.

Relationship of triglyceride-glucose index and its derivatives with blood pressure abnormalities in adolescents: an analysis based on a restricted cubic spline model / 中国当代儿科杂志

OBJECTIVES@#To explore the relationship of triglyceride-glucose index (TyG), triglyceride-glucose-body mass index (TyG-BMI), and triglyceride-glucose-waist circumference index (TyG-WC) with blood pressure abnormalities in adolescents, providing theoretical basis for the prevention and control of hypertension in adolescents.@*METHODS@#A stratified cluster sampling method was used to select 1 572 adolescents aged 12 to 18 years in Yinchuan City for questionnaire surveys, physical measurements, and laboratory tests. Logistic regression analysis and restricted cubic spline analysis were employed to examine the relationship of TyG, TyG-BMI, and TyG-WC with blood pressure abnormalities in adolescents.@*RESULTS@#Multivariable logistic regression analysis revealed that after adjusting for confounding factors, the groups with the highest quartile of TyG, TyG-BMI, and TyG-WC had 1.48 times (95%CI: 1.07-2.04), 3.71 times (95%CI: 2.67-5.15), and 4.07 times (95%CI: 2.89-5.73) higher risks of blood pressure abnormalities compared to the groups with the lowest quartile, respectively. Moreover, as the levels of TyG, TyG-BMI, and TyG-WC increased, the risk of blood pressure abnormalities gradually increased (P<0.05). A non-linear dose-response relationship was observed between TyG-BMI and the risk of blood pressure abnormalities (P overall trend<0.001, P non-linearity=0.002). Linear dose-response relationships were found between TyG and the risk of blood pressure abnormalities (P overall trend<0.001, P non-linearit =0.232), and between TyG-WC and the risk of blood pressure abnormalities (P overall trend<0.001, P non-linearity=0.224).@*CONCLUSIONS@#Higher levels of TyG and its derivatives are associated with an increased risk of blood pressure abnormalities in adolescents, with linear or non-linear dose-response relationships.

Relationship Between Neck Circumference and Risk Factors of Metabolic Syndrome in a Bushehr Elderly Health Study.

Metabolic syndrome includes a set of metabolic disorders such as obesity, high blood pressure, hypertriglyceridemia, lipid disorders, and glucose intolerance. In this cross-sectional (descriptive-analytical) study, 2,426 people were selected from the 60 years old and above population of Bushehr for a second-phase investigation of the relationship between neck circumference (NC) and cardiometabolic risk factors in the elderly people. The data (mean and standard deviation) were analyzed using STATA MP Version 15 software. The results of the study showed that the average age of all elderly participants in the study was 69.34 ± 6.39 years. The mean and standard deviation of the NC index in men, women, and all participants were 39.31 ± 2.89, 34.86 ± 2.84, and 37.00 ± 3.62, respectively. The mean and standard deviation of most laboratory indicators (triglyceride [TG], total cholesterol [TC], low-density lipoprotein [LDL], high-density lipoprotein [HDL]) were significantly higher in women, and there was no significant difference in fasting blood glucose (FBG) between men and women. NC index in the total population was significantly associated with all risk factors of metabolic syndrome (body mass index, systolic blood pressure, diastolic blood pressure) and laboratory indicators (FBG, TG, TC, LDLC, and HDL). The present study shows that the NC index can be a good predictor for the diagnosis of metabolic syndrome and visceral adipose tissue in the elderly.

Association between weight-adjusted-waist index and heart failure: Results from National Health and Nutrition Examination Survey 1999-2018.

Background: Weight-adjusted waist circumference index (WWI) is a novel index positively associated with excessive fat accumulation. The current study aims to evaluate the association between WWI and the prevalent heart failure (HF), and to assess the value of WWI to improve the detection of HF in the general population. Methods: A total of 25,509 subjects from National Health and Nutrition Examination Survey 1999-2018 were included into our study. WWI was calculated as WC (cm) divided by the square root of weight (kg). HF was identified according to the subjects' reports. Results: The prevalence of reported HF was 2.96%. With adjustment of demographic, anthropometric, laboratory, and medical history data, one SD increment of WWI could cast an additional 19.5% risk for prevalent HF. After separating WWI into quartiles, the fourth quartile had a 1.670 times risk of prevalent HF compared to the first quartile. Furthermore, smooth curve fitting suggested that the association was linear in the entire range of WWI. Moreover, the association was robust to subgroups of age, sex, race, obesity, hypertension, and diabetes. Additionally, ROC analysis revealed a significant improvement for the detection of prevalent HF from WWI (0.890 vs. 0.894, P < 0.001); And continuous net reclassification index (0.225, P < 0.001) and integrated discrimination index (0.004, P < 0.001) also supported the improvement from WWI. Conclusion: Our data demonstrated a significant, linear, and robust association between WWI, a simple surrogate for fat mass accumulation, and the risk for prevalent HF in a representative population. Moreover, our results also suggested the potential value of WWI to refine the detection of prevalent HF in the general population.

Circumference characteristics of Tibetan-Burman adults / 解剖学报

Objective To investigate the characteristics of bod)' circumference of Tibetan-Burman adults. Methods Using a human bod)' altimeter and a measuring tape, the height and 9 circumference indicators of 14 722 adults from 17 Tibetan-Bunnan ethnic groups in Sichuan, Yunnan, Guizhou, Hubei, Hu ' nan and Tibet Autonomous Region were measured from 2015 to 2019, 5 circumference indexes were calculated, and the data were statistically analyzed. Results The higher the longitude, the larger the head circumference, thigh circumference, biceps circumference and foreann circumference of Tibetan-Bunnan adults and the female maximum biceps circumference, and the smaller the trunk circumferences and male calf circumference; The higher the latitude, the larger the circumferences (except for female thigh circumference); The higher the altitude, the larger the circumferences; The higher the temperature, the smaller the circumferences. Conclusion Among the 17 ethnic groups of Tibeto-Burman, the Tibetan has a larger circumference, while the Gongshan Nu, Lahu, and Drung have relatively small and close circumferences. With age, the chest and waist circumferences of Tibetan-Bunnan adults increase, and the circumference of the limbs decreases.

The Relation between Head Circumference and Mid-Pelvic Circumference: A Simple Index for Cephalopelvic Disproportion Evaluation.

INTRODUCTION: Cephalopelvic disproportion (CPD) is one of the most common obstetric complications. Since CPD is the disproportion between the fetal head and maternal bony pelvis, evaluation of the head circumference (HC) relative to the maternal bony pelvis may be a useful adjunct to pre-labor CPD evaluation. The aim of the present study was a proof-of-concept evaluation of the ratio between HC and pelvic circumference (PC) as a predictor of CPD. METHODS: Of 11,822 deliveries, 104 cases that underwent an abdominopelvic CT for any medical indication and who underwent normal vaginal deliveries (NVDs) (n = 84) or cesarean deliveries (CD) due to CPD (n = 20) were included retrospectively. Maternal pelvis dimensions were reconstructed and neonatal HC, as a proxy for fetal HC, was measured. The correlation between cases of CPD and cephalopelvic circumference index (CPCI), which represents the ratio between the HC and PC in percentage (HC/PC × 100), was evaluated. RESULTS: The mid-pelvis CPCI (MP-CPCI) was larger in CD groups as compared to the NVD group: 103 ± 11 versus 97 ± 8%, respectively (p = 0.0003). In logistic regression analysis, the MP-CPCI was found to be independently associated with CD due to CPD: each 1% increase in MP-CPCI increased the likelihood of CD for CPD by 11% (adjusted odds ratio [aOR] 1.11, 95% CI, 1.03-1.19, p = 0.004). The aOR for CD due to CPD increased incrementally as the MP-CPCI increased, from 3.56 (95% CI, 1.01-12.6) at MP-CPCI of 100 to 5.6 (95% CI, 1.63-19.45) at 105, 21.44 (95% CI, 3.05-150.84) at 110, and 28.88 (95% CI, 2.3-362.27) at MP-CPCI of 115. CONCLUSIONS: The MP-CPCI, representing the relative dimensions of the fetal HC and maternal PC, is a simple tool that can potentially distinguish between parturients at lower and higher risk of CPD. Prospective randomized studies are required to evaluate the feasibility of prenatal pelvimetry and MP-CPCI to predict the risk of CPD during labor.

Propuesta de un indicador para sobrepeso y obesidad: índicepeso-circunferencia de cintura (IPCC) / Proposal of an indicator for overweight and obesity: weight-circumference waist index (WCWI)

El objetivo es evaluar el IPCC, para proponerlo como indicador de sobrepeso y obesidad. Es un estudio descriptivo, prospectivo, transversal y correlacional, en una muestra de 896niños y adolescentes con edad de 6 y 19 años; 452 (50,4%)del sexo masculino y 444 (49,6%) del sexo femenino. Métodos: Se midieron las variables sexo, edad, peso, talla, IMC, PGC e IPCC; se determinaron promedios, desviación, correlaciones y curva ROC. Resultados: promedios de peso 43,1±14,8 kg; talla 146,2±15,8 cm; IMC 19,6±3,6 kg/m2; CC 66,7±9,3 cm; IPCC 0,64±0,2 y PGC 15,5±7,3. Correlaciones muy buenas entre Talla-Peso (0,87); Peso-IMC (0,84); Peso-IPCC (0,91);Talla-IPCC (0,80) e IMC-IPCC (0,75); porcentajes resultantes de clasificar a niños y adolescentes, según valores del IMC eI PCC, y los tres criterios asumidos como referencias, indican que: Sobrepeso 10,9% (IMC) y 11,6% (IPCC); Obesidad 5,3%(IMC) y 5,8% (IPCC). Para el criterio Media y Desviación, Sobrepeso 4,1% (IMC) y 8,1% (IPCC); Obesidad 0,3% (IMC)y 4,2% (IPCC). Para el criterio Fundacredesa, Sobrepeso 7,2%(IMC) y 8,0% (IPCC); Obesidad 3,3% (IMC) y 3,6% (IPCC).Promedios, por sexo, para las variables peso, talla, IMC, CC eI PCC, no significativos; si los promedios del PGC (p<0,000).Curva ROC se aleja de la diagonal, aunado al hecho que el área bajo la curva es 0,983, refleja la bondad del modelo, complementado con una alta sensibilidad y especificidad, garantizado así un al poder discriminante. Conclusión: Curva ROC del IPCC, con área bajo la curva es 0,983, alta sensibilidad y especificidad, con capacidad discriminante(AU)

The objective is to evaluate the WCWI, to propose it as an indicator of overweight and obesity. It is a descriptive, prospective, cross-cutting and correlational study, in a sample of 896 children and adolescents aged 6 and 19; 452 (50.4%)444 (49.6%) of the female sex. Methods: the variables sex, age, weight, size, BMI, BFP and WCWI were measured; averages, deviation, correlations and ROC curve were determined. Results: weight averages 43.1±14.8 kg; size 146.2±15.8 cm; BMI 19.6±3.6 kg/m2; WC 66.7±9.3 cm; WCWI 0.64±0.2 and BFP 15.5±7.3. Very good correlations between Size-Weight (0.87); Weight-BMI (0.84); WCWI-Weight (0.91);Size-WCWI (0.80) and BMI-WCWI (0.75); percentage Revista Digital de Postgrado, 2021, 10(3), e325, Septiembre-Diciembre, ISSN: 2244-761XPDF generado a partir de XML-JATS4 Rresulting from classifying children and adolescents, accordingto BMI and WCWI values, and the three criteria assumed as references, indicate that: Overweight 10.9% (BMI) and 11.6%(WCWI); Obesity 5.3% (BMI) and 5.8% (WCWI); for the Mean and Deviation criterion, Overweight 4.1% (BMI) and8.1% (WCWI); Obesity 0.3% (BMI) and 4.2% (WCWI).For the Fundacredesa criterion, Overweight 7.2% (BMI) and8.0% (WCWI); Obesity 3.3% (BMI) and 3.6% (WCWI).Averages by sex, for non-significant weight, size, BMI, WC and WCWI variables; BFP averages (p<0.000). ROC curvemoves away from the diagonal, coupled with the fact that thearea under the curve is 0.983, reflects the goodness of themodel, complemented by a high sensitivity and specificity, thusguaranteed a discriminating power. Conclusion: WCWI ROC curve, with are a under the curve is 0.983, high sensibility and specificity, with discriminating capacity(AU)

Índices triglicéridos-glucosa como estimadores de insulinorresistencia en personas con riesgo de desarrollar diabetes tipo 2 / Triglyceride-glucose indices as estimators of insulin resistance in people at risk of developing type 2 diabetes

EL HOMA-IR (homeostasis model assessment-insulin-resistance) es un estimador de insulinorresistencia (IR) pero depende de la determinación de insulina. Los índices triglicéridos-glucosa (T-G)-circunferencia de la cintura (CC) (T-G-CC) o triglicéridos-glucosa-índice de masa corporal (TG- IMC) podrían ser sustitutos. Los objetivos de este trabajo consistieron en investigar en personas con riesgo de desarrollar diabetes tipo 2 (DT2): a) los índices T-G, T-G-CC y T-G-IMC como estimadores de HOMA-IR>2,1; b) determinar su poder discriminante. Se realizó un estudio prospectivo en el que se estudiaron 223 individuos ≥45 años con riesgo de desarrollar diabetes tipo 2 (DT2). La relación T-G se calculó como ln [triglicéridos (mg/dL) x glucemia (mg/dL)/2]. La relación T-G-CC y T-G-IMC fue el producto de T-G por CC o IMC. Se utilizó análisis de regresión logística y se calcularon las áreas bajo las curvas ROC (receiver operating characteristic curves) (ABC) para comparar las asociaciones de T-G, T-G-CC y T-G-IMC con HOMA-IR>2,1. Mediante análisis discriminante se evaluó la clasificación de los sujetos entre HOMA-IR>2,1 y HOMA-IR≤2,1. ABC, sensibilidad, especificidad, poder predictivo positivo y negativo para T-G-CC y T-G-IMC fueron mayores que para T-G, con los siguientes valores de corte: T-G=8,75, T-G-CC=821 y T-G-IMC=255. Los odds ratios (OR) para HOMA-IR>2,1, ajustados para confusores, fueron: T-G>8,75, OR: 4,85 (IC 95% 2,73-8,62); T-G-CC>821, OR: 10,41 (IC 95% 5,55-19,53); T-GIMC> 255, OR: 10,41 (IC 95% 5,55-19,53). Con el análisis discriminante T-G>8,75 clasificó correctamente 69,2% individuos con HOMA-IR≤2,1 y 68,3% con HOMA-IR>2,1; T-G-CC y T-G-IMC clasificaron 74,4% y 78,2% respectivamente (p<0,001 en todos los casos). Se concluyó que T-GCC> 821 y T-G-IMC>255 fueron mejores estimadores de HOMA-IR>2,1 que T-G>8,75. Estas son determinaciones simples y accesibles y podrían ser útiles en la práctica clínica y en estudios epidemiológicos.

HOMA-IR ((homeostasis model assessment-insulin-resistance) is a surrogate estimator of insulin resistance (IR) but it depends on insulin determination. Triglyceride-glucose-waist circumference (T-G-WC) or triglyceride-glucose-body mass index (BMI) (T-G-BMI) could be substitutes. The objectives of this work were: to investigate in people at risk of developing type 2 diabetes (T2D): a) T-G, T-G-CC and T-G-BMI as estimators of HOMA-IR>2.1 and b) to determine their discriminating power. A prospective study was conducted studying 223 individuals ≥45 years of age at risk of developing type 2 diabetes (T2D). The T-G ratio was calculated as ln [triglycerides (mg/dL) x glycemia (mg/dL)/2]. The T-G-CC and T-G-BMI ratio was the product of T-G by CC or BMI. Logistic regression analysis was used and the areas under the receiver operating characteristic curves (ROC) curves were calculated to compare the associations of T-G, T-G-CC and T-G-BMI with HOMA-IR>2.1. Using a discriminant analysis, the classification of the subjects between HOMA-IR>2.1 or HOMA-IR≤2.1 was evaluated. AUC, sensitivity, specificity, positive and negative predictive powers for T-G-CC and T-G-BMI were higher than for T-G, with the following cut-off values: TG=8.75, T-G-CC=821 and T-G-BMI=255. Odds ratios (OR) for HOMA-IR>2.1, adjusted for confounders, were: T-G>8.75, OR 4.85 (95% CI 2.73-8.62); T-G-CC>821, OR 10.41 (95% CI 5.55-19.53); T-G-BMI>255, OR 10.41 (95% CI 5.55-19.53). With the discriminant analysis T-G>8.75, 69.2% correctly classified with HOMA-IR≤2.1 and 68.3% with HOMA-IR>2.1; T-G-CC and T-G-BMI correctly classified 74.4% and 78.2% respectively (p <0.001 in all cases). It is concluded that T-G-CC>821 and T-G-BMI>255 were better estimators of HOMA-IR>2.1 than T-G>8.75. T-G-WC and T-G-BMI are simple and reliable determinations and could be useful in clinical practice and epidemiological studies.

O HOMA-IR (homeostasis model assessment-insulin-resistance) e um estimador de resistencia a insulina (RI), mas depende da determinacao da insulina. Triglicerideos-glicose (T-G), circunferencia da cintura (CC) (T-G-CC) ou triglicerideos-glicose-indice de massa corporal (T-G-IMC) poderiam ser substitutos. Os objetivos desse trabalho foram investigar em pessoas com risco de desenvolver diabetes tipo 2 (DT2): a) os indices T-G, T-G-CC e T-G-IMC como estimadores de HOMA-IR> 2,1; b) determinar seu poder discriminante. Um estudo prospectivo foi realizado em 223 pessoas ≥45 anos com risco de desenvolver diabetes tipo 2 (DT2). A razao T-G foi calculada como ln [triglicerideos (mg/dL) x glicemia (mg/dL)/2]. A razao T-G-CC e T-G-IMC foi o produto de T-G por CC ou IMC. A analise de regressao logistica foi utilizada e as areas sob as curvas ROC (receiver operating features) ABC foram calculadas para comparar as associacoes de T-G, T-G-CC e T-G-IMC com HOMA-IR>2.1. Por meio de analise discriminante, avaliou-se a classificacao dos sujeitos entre HOMA-IR>2,1 e HOMA-IR≤2,1. ABC, sensibilidade, especificidade, poder preditivo positivo e negativo para TG-CC e TG-IMC foram maiores que para TG, com os seguintes valores de corte: TG=8,75, TG-CC=821 e TG-IMC=255. Odds Ratios (OR) para HOMA-IR>2,1, ajustados para fatores de confusao, foram: TG>8,75, OR 4,85 (IC95% 2,73-8,62); T-G-CC>821, OR 10,41 (IC 95% 5,55-19,53); T-G-IMC>255, OR 10,41 (IC 95% 5,55-19,53). Com a analise discriminante T-G>8,75, 69,2% foram classificados corretamente com HOMA-IR≤2,1 e 68,3% com HOMA-IR>2,1; T-G-CC e T-G-IMC classificaram 74,4% e 78,2%, respectivamente (p<0,001 em todos os casos). Conclui-se que T-G-CC>821 e TG- IMC>255 foram melhores estimadores de HOMA-IR>2,1 que T-G>8,75. Elas sao determinacoes simples e acessiveis e poderiam ser uteis na pratica clinica e em estudos epidemiologicos.

Association of the hypertriglyceridemic waist phenotype and severity of acute pancreatitis.

BACKGROUND: The aim of this study was to evaluate the effect of a simple visceral obesity phenotype, known as the hypertriglyceridemic waist phenotype and its quantitative indicator waist circumference index on the severity of acute pancreatitis. MATERIALS AND METHODS: Diagnosis and severity analysis of acute pancreatitis were determined according to the Atlanta classification guidelines, revised in 2012. We considered the hypertriglyceridemic waist phenotype as characterized by increased waist circumference and elevated triglyceride concentrations. We investigated the association between the acute pancreatitis severity and hypertriglyceridemic waist phenotype, including waist circumference index. RESULTS: The hypertriglyceridemic waist phenotype was significantly associated with systemic inflammatory response syndrome, organ failure, and severe acute pancreatitis. The median waist circumference index and demonstration of hypertriglyceridemic waist phenotype were positively correlated with acute pancreatitis severity. In addition, multivariate logistic analysis showed that patients with the hypertriglyceridemic waist phenotype had 1.664 times the risk of organ failure and 1.891 times the risk of systemic inflammatory response syndrome, compared with the other groups. CONCLUSION: Upon admission, the hypertriglyceridemic waist phenotype was strongly associated with acute pancreatitis in patients. This phenotype, including waist circumference index, might be a simple method for evaluating individuals at high risk of severe acute pancreatitis.

Length-chest circumference index of 13776 cases normal term newborn in different gestational ages / 临床儿科杂志

Objective To obtain the length-chest circumference index of normal term newborns in different gestational age. Methods By cross-sectional time cluster sampling fact-ifnding investigation method, the anthropometric data on 16388 newborns from 2013 to 2015 were measured, including birth weight, length, crown-rump length, head circumference, and chest circumference, to develop normal full-term infants height chest circumference index (BCI) in different gestational age. Results Anthropometric data of 13776 normal term infants were available at the end of the study. The BCI, Ververck Index (VI), Elisma index (EI) were increasing with the gestational age at newborn. BCI, VI, EI in male is less than those of female with signiifcant difference (P<0.05). There were some differences of newborn’s BCI, VI and EI in 2015 than those in 2005. Conclusion Com-pared to ten years ago, chest fullness increased with gestational age at different gestational ages in normal full-term infants, and the chest fullness in male is less than that in female.