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1.
Afr J Prim Health Care Fam Med ; 16(1): e1-e7, 2024 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-38949442

RESUMO

BACKGROUND:  Clustering of cardiovascular disease (CVD) risk factors have been observed in children and adolescents, but its association with visceral adiposity index (VAI) and cardiorespiratory fitness (CRF) in adolescents has rarely been studied. AIM:  This study determines the independent associations of VAI and CRF with the clustering of cardiovascular disease risk (CVDr) among Nigerian adolescents. SETTING:  Adolescents from specific secondary schools in Kogi East, North Central Nigeria participated in the study. METHODS:  A cross-sectional sample of 403 adolescents (202 boys and 201 girls) aged 11 years - 19 years were evaluated for VAI, CRF and CVDr. Using identified risk factors, a clustered CVDr score was generated. The association between VAI, CRF and clustered CVDr was evaluated using regression models that controlled for age, gender and maturity status. RESULTS:  Fitness was negatively associated with CVDr (ß = -0.268, p  0.001), while VAI was positively correlated with CVDr (ß = 0.379, p  0.001). After CRF or VAI adjustment, the independent association with the dependent variable remained significant. The odds of an adolescent with elevated VAI being at risk of CVD was 4.7 times higher than his peers. Unfit adolescents were 2.1 times more likely to develop CVDr. CONCLUSION:  Both VAI and CRF were independently associated with the clustering of CVDr in Nigerian adolescents. The findings suggest that health promotion efforts focusing on healthy diet and aerobic-type physical activity programmes should be encouraged among the youth to reduce the risk of CVD.Contribution: This study shows that improving visceral adipose tissue and fitness may lower CVD risk factors in adolescents, which is significant for public health.


Assuntos
Aptidão Cardiorrespiratória , Doenças Cardiovasculares , Obesidade Abdominal , Humanos , Masculino , Adolescente , Feminino , Nigéria/epidemiologia , Estudos Transversais , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Aptidão Cardiorrespiratória/fisiologia , Criança , Obesidade Abdominal/epidemiologia , Fatores de Risco de Doenças Cardíacas , Gordura Intra-Abdominal , Fatores de Risco , Adulto Jovem
2.
BMC Infect Dis ; 24(1): 676, 2024 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-38971751

RESUMO

BACKGROUND: Recent studies on the association between Helicobacter pylori (H. pylori) infection and obesity have reported conflicting results. Therefore, the purpose of our study was to investigate the association of obesity, abdominal obesity, and metabolic obesity phenotypes with H. pylori infection. METHODS: A cross-sectional study of 1568 participants aged 20 to 85 was conducted using the National Health and Nutrition Examination Survey (NHANES) cycle 1999-2000. Logistic regression models were employed to evaluate the association of general obesity as defined by body mass index (BMI), abdominal obesity as defined by waist circumference (WC) and waist-height ratio (WHtR), and metabolic obesity phenotypes with H. pylori seropositivity. Subgroup analyses stratified by age were conducted to explore age-specific differences in this association. RESULTS: After grouping individuals according to their WHtR, the prevalence rate of WHtR ≥ 0.5 in H. pylori-seropositive participants was significantly higher than that in H. pylori-seronegative participants (79.75 vs. 68.39, P < 0.001). The prevalence of H. pylori seropositivity in non-abdominal obesity and abdominal obesity defined by WHtR was 24.97% and 31.80%, respectively (P < 0.001). In the subgroup analysis, the adjusted association between abdominal obesity, as defined by the WHtR, and H. pylori seropositivity was significant in subjects aged < 50 years (OR = 2.23; 95% CI, 1.24-4.01; P = 0.01) but not in subjects aged ≥ 50 years (OR = 0.84; 95% CI, 0.35-1.99; P = 0.66). Subjects older than 50 years old had an OR (95% CI) for metabolically healthy obesity of 0.04 (0.01-0.35) compared with the control group. H. pylori seropositivity was consistently not associated with obesity as defined by BMI. CONCLUSIONS: Abdominal obesity, as defined by the WHtR, was associated with H. pylori infection in subjects aged ≤ 50 years.


Assuntos
Infecções por Helicobacter , Helicobacter pylori , Inquéritos Nutricionais , Obesidade Abdominal , Obesidade , Humanos , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/complicações , Pessoa de Meia-Idade , Adulto , Masculino , Feminino , Estudos Transversais , Idoso , Obesidade/microbiologia , Obesidade/epidemiologia , Idoso de 80 Anos ou mais , Adulto Jovem , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/microbiologia , Prevalência , Fenótipo , Índice de Massa Corporal
3.
Nutrients ; 16(13)2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38999845

RESUMO

BACKGROUND: Childhood overweight and obesity is a global concern and has increased in Spain over the last decades. Combinations of lifestyle behaviors (i.e., diet, sleep, and sedentarism) are highly related to weight status. Therefore, this study aimed to identify lifestyle patterns among children from Madrid City, and analyze associations with the prevalence of overweight, obesity, and abdominal obesity, considering socio-economic factors. METHODS: A cross-sectional analysis was conducted on 4545 children from the ENPIMAD study with data on diet, sleep, anthropometric, and socio-economic variables. K-means cluster analysis was used to identify lifestyle clusters, and logistic regressions were used to examine the associations between socio-economic indicators and cluster membership, and between clusters and weight status. RESULTS: Findings show three lifestyle clusters (healthy, mixed, and unhealthy), with boys and older children more represented in the unhealthy cluster. Food insecurity and low socio-economic status were associated with unhealthier clusters in boys and girls. Children in unhealthier clusters were more likely to have obesity and abdominal obesity. However, these associations disappeared in girls after controlling for food insecurity. CONCLUSION: These results provide insight into the combination of behaviors and socio-economic factors associated with childhood obesity that may aid in the design of future interventions.


Assuntos
Dieta , Estilo de Vida , Obesidade Infantil , Tempo de Tela , Sono , Humanos , Masculino , Feminino , Espanha/epidemiologia , Criança , Obesidade Infantil/epidemiologia , Estudos Transversais , Dieta/estatística & dados numéricos , Fatores Socioeconômicos , Análise por Conglomerados , Peso Corporal , Obesidade Abdominal/epidemiologia , Prevalência , Insegurança Alimentar , Sobrepeso/epidemiologia
4.
BMC Gastroenterol ; 24(1): 221, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38987694

RESUMO

BACKGROUND: Obesity has become a major global public health challenge. Studies examining the associations between different obesity patterns and the risk of nonalcoholic fatty liver disease (NAFLD) are limited. This study aimed to investigate the relationships between different obesity patterns and the risk of NAFLD in a large male population in the US. METHODS: Data from the 2017 to March 2020 National Health and Nutrition Examination Survey (NHANES) were utilized. Liver steatosis and fibrosis were assessed with FibroScan using the controlled attenuation parameter (CAP) and liver stiffness measurements (LSM). Steatosis was identified with a CAP value of 248 dB/m or higher. Abdominal obesity was defined by a waist circumference (WC) of 102 cm or more for males and 88 cm or more for females. Overweight was defined as a body mass index (BMI) of 24.0 kg/m2 and above. General obesity was identified with a BMI of 28.0 kg/m2 or higher. Obesity status was categorized into four types: overweight, general obesity, abdominal obesity, and combined obesity. Multivariate logistic regression, adjusting for potential confounders, was used to examine the link between obesity patterns and NAFLD risk. Subgroup analysis further explored these associations. RESULTS: A total of 5,858 adults were included. After multivariable adjustment, compared to the normal weight group, the odds ratios (ORs) [95% confidence interval (CI)] for NAFLD in individuals with overweight, general obesity, abdominal obesity, and combined obesity were 6.90 [3.74-12.70], 2.84 [2.38-3.39], 3.02 [2.02-4.51], and 9.53 [7.79-11.64], respectively. Subgroup analysis showed the effect of different obesity patterns on NAFLD risk was stable among individuals with different clinical conditions. In the fully adjusted multivariate logistic regression model, WC was positively associated with NAFLD risk (OR: 1.48; 95% CI: 1.42-1.53; P < 0.001). WC also demonstrated strong discriminatory ability for NAFLD in Receiver Operating Characteristic (ROC) analysis, achieving an Area Under the Curve (AUC) of 0.802. CONCLUSIONS: Different patterns of obesity are risk factors for NAFLD. An increase in WC significantly increased NAFLD risk. More attention should be paid to preventing different patterns of obesity among adults.


Assuntos
Técnicas de Imagem por Elasticidade , Hepatopatia Gordurosa não Alcoólica , Inquéritos Nutricionais , Obesidade , Humanos , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/complicações , Masculino , Estudos Transversais , Obesidade/complicações , Obesidade/epidemiologia , Pessoa de Meia-Idade , Adulto , Fatores de Risco , Feminino , Índice de Massa Corporal , Circunferência da Cintura , Estados Unidos/epidemiologia , Obesidade Abdominal/complicações , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/diagnóstico por imagem , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/epidemiologia , Sobrepeso/complicações , Sobrepeso/epidemiologia
5.
Nutr J ; 23(1): 77, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39010085

RESUMO

BACKGROUND & AIMS: Obesity has been linked to various detrimental health consequences. While there is established evidence of a negative correlation between seafood consumption and obesity in adults, the current research on the association between seafood intake in childhood/adolescence and the risk of obesity is lacking. Our aim was to evaluate the association between seafood intake in childhood/adolescence and the risk of obesity in a Chinese nationwide cohort. METHODS: We utilized data from the China Health and Nutrition Survey (CHNS) from the year of 1997 to 2015. Seafood consumption was evaluated through 3-day 24-hour recalls. In our study, overweight/obesity status was determined based on the Chinese Criteria of Overweight and Obesity in School-age Children and Adolescents (WS/T 586-2018), while abdominal obesity status was determined according to the Chinese Criteria of Waist Circumference Screening Threshold among Children and Adolescents (WS/T 611-2018). RESULTS: During an average follow-up of 7.9 years, 404 cases developed overweight/obesity among 2206 participants in the seafood-overweight/obesity analysis, while 381 cases developed abdominal obesity among 2256 participants in the seafood-abdominal-obesity analysis. The high-consumer group was associated with 35% lower risk of overweight/obesity risk and 26% lower risk of abdominal obesity after fully adjusting for sociodemographic and lifestyle factors, compared with the non-consumer group. Considering different cooking methods, boiled seafood consumption was associated with 43% lower risk of overweight/obesity and 23% lower risk of abdominal obesity in the fully adjusted model, while stir-fried seafood did not demonstrate a statistical significance. CONCLUSION: Higher intake of seafood in childhood/adolescents, particularly in a boiled way, was associated with lower obesity risk.


Assuntos
Inquéritos Nutricionais , Alimentos Marinhos , Humanos , Criança , Feminino , Adolescente , Masculino , Alimentos Marinhos/estatística & dados numéricos , China/epidemiologia , Estudos de Coortes , Inquéritos Nutricionais/estatística & dados numéricos , Inquéritos Nutricionais/métodos , Fatores de Risco , Obesidade Infantil/epidemiologia , Dieta/estatística & dados numéricos , Dieta/métodos , Dieta/efeitos adversos , Obesidade Abdominal/epidemiologia , Sobrepeso/epidemiologia
6.
Sci Rep ; 14(1): 16634, 2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39025982

RESUMO

Relationships between the visceral adiposity index (VAI) and type 2 diabetes mellitus (T2DM) have been underexplored. The purpose of this study is to explore association between VAI and T2DM in adults in the US. Based on the National Health and Nutrition Examination Survey 2007-2018, 11,214 participants aged 20 years or older were included in a cross-sectional study. Multifactorial logistic regression analysis and smoothed curve fitting analysis were performed to investigate links between VAI and the prevalence of T2DM, as well as the stability and incidence between subgroups. In a fully adjusted continuous model, the aggregate population risk of T2DM increased 0.43-fold with each 1-unit increase in VAI [odds ratio (OR) = 1.43; 95% confidence interval (CI) 1.35-1.50]. In the fully adjusted categorical model with VAI scores stratified by quartiles, results showed a higher T2DM advantage among participants in the second, third, and fourth quartiles (Q2: OR 1.35, 95% CI 1.06-1.71; Q3: OR 2.46, 95% CI 1.95-3.11; Q4: OR 4.42, 95% CI 3.55-05.50). Compared with Q1, the prevalence of T2DM in the total population increased 3.42-fold in Q4. The above results indicated that VAI was positively associated with the prevalence of T2DM, which was consistent and nonlinear with the smoothed curve-fitting analysis (P for non-linear = 0). Subgroup analyses after adjusting for covariates showed that keeping with the overall population results, it also was found that there was an interaction between sex and hypertension in the subgroups. VAI was positively associated with the prevalence of T2DM and was more prevalent in women, non-hypertensive than in men, hypertensive populations.


Assuntos
Adiposidade , Diabetes Mellitus Tipo 2 , Gordura Intra-Abdominal , Humanos , Diabetes Mellitus Tipo 2/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Estudos Transversais , Fatores de Risco , Prevalência , Obesidade Abdominal/complicações , Obesidade Abdominal/epidemiologia , Inquéritos Nutricionais , Idoso , Estados Unidos/epidemiologia , Adulto Jovem
7.
BMJ Open ; 14(7): e082601, 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39019627

RESUMO

OBJECTIVE: We aimed to assess the associations between sleep duration and Visceral Adiposity Index (VAI). DESIGN: Cross-sectional study. SETTING: The National Health and Nutrition Examination Survey (2007-2018). PARTICIPANTS: A total 11 252 eligible participants who have complete information for sleep duration and VAI. OUTCOME MEASURE: The VAI index, which is sex-specific and takes into consideration factors such as waist circumference, body mass index, high-density lipoprotein cholesterol and triglycerides, was calculated in accordance with prior research. Multiple linear regressions and subgroup analyses were employed to evaluate the connection between the duration of sleep and the VAI. RESULTS: The mean sleep duration and VAI of included participants were 7.05 hours/day and 2.03, respectively. After adjusting for the sociodemographic, lifestyle and other covariates, short sleep was significantly linked to increased VAI (ß=0.15, 95% CI 0.01 to 0.28) in relation to middle sleep duration, whereas no significant association was found between long sleep duration and VAI. An L-shaped relationship was observed between sleep duration and VAI. When sleep duration was less than 7.5 hours/day, a negative association between sleep duration and VAI was obvious. However, when sleep duration was >7.5 hours/day, VAI was increased with a longer sleep duration, although it was not significant. CONCLUSIONS: An L-shaped relationship was observed between sleep duration and VAI, with insufficient sleep, being independently linked to a higher VAI. This implies that sleep deprivation might be associated with visceral adipose distribution and disfunction.


Assuntos
Gordura Intra-Abdominal , Inquéritos Nutricionais , Obesidade Abdominal , Sono , Circunferência da Cintura , Humanos , Masculino , Feminino , Estudos Transversais , Pessoa de Meia-Idade , Adulto , Sono/fisiologia , Obesidade Abdominal/epidemiologia , Índice de Massa Corporal , Fatores de Tempo , Triglicerídeos/sangue , Idoso , Estados Unidos/epidemiologia , Adiposidade , Duração do Sono
8.
Rev Fac Cien Med Univ Nac Cordoba ; 81(2): 302-317, 2024 06 28.
Artigo em Espanhol | MEDLINE | ID: mdl-38941225

RESUMO

Introduction: Metabolic syndrome (MS) is associated with increased cardiovascular risk. Blood donors are an apparently healthy population in which certain cardiometabolic characteristics are not evaluated in their selection, and there is limited information on their presence. Aim: To determine the frequency of metabolic syndrome and its metabolic characteristics in blood donors. Materials and methods: Cross-sectional study was carried in a population of 244 blood donors between 18 and 55 years of age who attended the Hemotherapy and Blood Bank Service of the Cayetano Heredia Hospital in Lima, Perú during the month of May 2023. The diagnosis of MS was made according to the Adult Treatment Panel III (ATP III) criteria. A bivariate analysis was performed between MS and metabolic characteristics with sex and a significance level of 5% was considered. Results: 63.9% of blood donors were male. 43.6% of the population had MS. The most frequent characteristics found were hypertriglyceridemia (54.5%), abdominal obesity (51.2%) and high-density lipoprotein (HDL) low (48.8%). The age range of 40 to 49 years presented the highest frequency of MS (14.3%). Hypertriglyceridemia and high blood pressure were associated with male sex (p=0.003 and p=0.019 respectively), while low HDL was associated with female sex (p<0.001). Conclusions: Blood donors present an elevated frequency of MS. The detection of MS in apparently healthy populations as part of primary care could allow the formulation of strategies for early detection of cardiovascular risk factors.


INTRODUCCIÓN: El síndrome metabólico (SM) está asociado a un incremento del riesgo cardiovascular. Los donantes de sangre son una población aparentemente sana en donde ciertas características cardiometabolicas no son evaluadas en su selección, existiendo limitada información sobre su presencia. OBJETIVO: Determinar la frecuencia de síndrome metabólico y sus características metabólicas en donantes de sangre. Materiales y métodos: Estudio transversal realizado en 244 donantes de sangre entre 18 y 55 años que acudieron al Servicio de Hemoterapia y Banco de sangre del Hospital Cayetano Heredia en Lima- Perú, durante el mes de mayo del 2023. Se realizó el diagnóstico de SM según los criterios del Adult Treatment Panel III (ATP III). Se realizó un análisis bivariado entre el SM y características metabólicas con el sexo y se consideró un nivel de significancia del 5%. RESULTADOS: El 63.9% de los donantes de sangre fueron del sexo masculino. El 43.6 % de la población presentó SM. Las características más frecuentes fueron la hipertrigliceridemia (54.5%), obesidad abdominal (51.2%) y lipoproteina de alta densidad (HDL) bajo (48.8%). El rango de edad de 40 a 49 años presentó la mayor frecuencia de SM (14.3%). La hipertrigliceridemia y presión arterial elevada estuvieron asociadas al sexo masculino (p=0.003 y p=0.019 respectivamente), mientras que el HDL bajo al sexo femenino (p <0.001). CONCLUSIONES: Los donantes de sangre presentan una frecuencia elevada de SM. La detección de SM en poblaciones aparentemente sanas como parte de la atención primaria podría permitir formular estrategias de detección temprana de factores de riesgo cardiovascular.


Assuntos
Doadores de Sangue , Síndrome Metabólica , Humanos , Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , Masculino , Feminino , Doadores de Sangue/estatística & dados numéricos , Adulto , Estudos Transversais , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Peru/epidemiologia , Fatores de Risco , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/sangue , Fatores Sexuais , Distribuição por Sexo
9.
J Health Popul Nutr ; 43(1): 89, 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38902813

RESUMO

BACKGROUND: Childhood obesity and hypertension are growing concerns globally, especially in developing countries. This study investigated the association between overall and central obesity at baseline, and prehypertension or hypertension at follow-up among preadolescent school children in urban Karachi, Pakistan. METHODS: This is a sub study with cohort design embedded within a feasibility trial on School Health Education Program in Pakistan (SHEPP) in preadolescents aged 6-11 years, attending two private schools conducted from 2017 to 2019. Hypertension or prehypertension at follow-up were the outcomes and obesity or central obesity at baseline were the exposure variables. Hypertension was defined as systolic blood pressure and/or diastolic blood pressure ≥ 95th percentile for age, sex, and height. Obesity was defined as body mass index for-age and sex ≥ 95th percentile, whereas central obesity was determined by waist circumference measurements ≥ 85th percentile of age, sex, and height specific cut-offs. Logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to identify risk factors for hypertension and prehypertension. RESULTS: Analysis was conducted for 908 participants, evenly distributed with 454 boys and 454 girls. Hypertension was observed in 19.8% of the preadolescents, with rates of 18.5% in boys and 21.0% in girls. Prehypertension was found in 16.8% of preadolescents, with 18% among boys and 16% among girls. Additionally, 12.8% of preadolescents were classified as obese and 29.8% had central obesity. Obesity at baseline was associated with hypertension at followup (OR 8.7, 95% CI 3.5, 20.4) in the final model after adjusting for age, gender, physical activity, sedentary behavior, fruits, vegetable intake and hypertension at baseline. Central obesity at baseline also yielded high odds, with prehypertension (OR 1.9, 95% CI 1.4, 2.8) and hypertension (OR 2.7, 95% CI 1.9, 3.9) at follow up in the final model. CONCLUSION: This study highlights a concerning prevalence of hypertension and prehypertension among preadolescent school-going children. Obesity and central obesity at baseline emerged as significant predictive factors for hypertension or prehypertension at followup within this cohort. The findings emphasize the urgency of implementing comprehensive school health education programs aimed at early detection and effective management of hypertension during childhood and adolescence in school settings.


Assuntos
Hipertensão , Obesidade Infantil , População Urbana , Humanos , Masculino , Feminino , Criança , Paquistão/epidemiologia , Hipertensão/epidemiologia , Obesidade Infantil/epidemiologia , Fatores de Risco , População Urbana/estatística & dados numéricos , Pré-Hipertensão/epidemiologia , Estudos de Coortes , Prevalência , Obesidade Abdominal/epidemiologia , Índice de Massa Corporal , Serviços de Saúde Escolar , Instituições Acadêmicas
10.
J Health Popul Nutr ; 43(1): 98, 2024 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-38926790

RESUMO

PURPOSE: There is a major epidemic of obesity, and many obese patients suffer from respiratory symptoms and disease. However, limited research explores the associations between abdominal obesity and lung function indices, yielding mixed results. This study aims to analyze the association between waist circumference (WC), an easily measurable marker of abdominal obesity, and lung function parameters in middle-aged and older adults using the National Health and Nutrition Examination Survey (NHANES). METHODS: This study utilized data obtained from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2012, with a total sample size of 6089 individuals. A weighted multiple regression analysis was conducted to assess the relationship between WC and three pulmonary function parameters. Additionally, a weighted generalized additive model and smooth curve fitting were applied to capture any potential nonlinear relationship within this association. RESULTS: After considering all confounding variables, it was observed that for each unit increase in WC, in males, Forced Vital Capacity (FVC) increased by 23.687 ml, Forced Expiratory Volume in one second (FEV1) increased by 12.029 ml, and the FEV1/FVC ratio decreased by 0.140%. In females, an increase in waist circumference by one unit resulted in an FVC increase of 6.583 ml and an FEV1 increase of 4.453 ml. In the overall population, each unit increase in waist circumference led to a FVC increase of 12.014 ml, an FEV1 increase of 6.557 ml, and a decrease in the FEV1/FVC ratio by 0.076%. By constructing a smooth curve, we identified a positive correlation between waist circumference and FVC and FEV1. Conversely, there was a negative correlation between waist circumference and the FEV1/FVC ratio. CONCLUSIONS: Our findings indicate that in the fully adjusted model, waist circumference, independent of BMI, positively correlates with FVC and FEV1 while exhibiting a negative correlation with FEV1/FVC among middle-aged and older adults in the United States. These results underscore the importance of considering abdominal obesity as a potential factor influencing lung function in American middle-aged and older adults.


Assuntos
Pulmão , Inquéritos Nutricionais , Obesidade Abdominal , Circunferência da Cintura , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Idoso , Obesidade Abdominal/epidemiologia , Pulmão/fisiopatologia , Pulmão/fisiologia , Capacidade Vital , Volume Expiratório Forçado , Testes de Função Respiratória , Estudos Transversais , Índice de Massa Corporal
11.
BMC Nephrol ; 25(1): 193, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862924

RESUMO

BACKGROUND: Obesity is an important risk factor for kidney stones(KS). Chinese Visceral Adiposity Index (CVAI), as a specific indicator for visceral obesity in the Chinese population, can more accurately assess the visceral fat content in Chinese individuals compared to Visceral Adiposity Index (VAI). However, the association between CVAI and risk for KS has not been studied. METHODS: A total of 97,645 participants from a health screening cohort underwent ultrasound examinations for the diagnosis of kidney stones, along with measurements of their CVAI. Logistic regressions were utilized to determine the relationship between different quartiles of CVAI and the incidence of kidney stones. Simultaneously, subgroup analysis and the computation of dose-response curves were employed to pinpoint susceptible populations. RESULTS: Among the participants, 2,888 individuals (3.0%) were diagnosed with kidney stones. The mean CVAI values ± standard deviation for the four groups were: Q1 (18.42 ± 19.64), Q2 (65.24 ± 10.39), Q3 (98.20 ± 9.11), and Q4 (140.40 ± 21.73). In the fully adjusted multivariable model, CVAI was positively correlated with urolithiasis (OR = 1.001; 95% CI = 1.000, 1.002). Compared with the first quartile of CVAI, the population in the fourth quartile of CVAI had a higher prevalence of kidney stones (OR = 1.231; 95% CI = 1.066, 1.415). Through subgroup analysis, a positive correlation between CVAI and the risk of kidney stones was found in non-smokers (OR = 1.001, 95%CI:1.000, 1.002), non-drinkers (OR = 1.001, 95%CI:1.000, 1.002), non-hypertensive subgroups (OR = 1.003, 95%CI:1.002, 1.003), and non-diabetes subgroups (OR = 1.001, 95%CI:1.000, 1.002). CONCLUSION: The findings suggest that CVAI could be a reliable and effective biomarker for assessing the potential risk of kidney stone prevalence, with significant implications for the primary prevention of kidney stones and public health.


Assuntos
Gordura Intra-Abdominal , Cálculos Renais , Obesidade Abdominal , Ultrassonografia , Humanos , Masculino , Feminino , Cálculos Renais/epidemiologia , Cálculos Renais/diagnóstico por imagem , Estudos Transversais , Pessoa de Meia-Idade , China/epidemiologia , Adulto , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/complicações , Obesidade Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/diagnóstico por imagem , Fatores de Risco , Programas de Rastreamento/métodos , Adiposidade , Idoso , População do Leste Asiático
12.
Sci Rep ; 14(1): 12645, 2024 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-38825630

RESUMO

Metabolic dysfunction-associated fatty liver disease (MAFLD) and chronic kidney disease (CKD) present notable health challenges, however, abdominal obesity has received scant attention despite its potential role in exacerbating these conditions. Thus, we conducted a retrospective cohort study using the National Health and Nutrition Examination Surveys III (NHANES III) of the United States from 1988 to 1994 including 9161 participants, and mortality follow-up survey in 2019. Statistical analyze including univariable and multivariable Logistic and Cox regression models, and Mediation effect analyze were applied in study after adjustment for covariates. Our findings revealed that individuals with both abdominal obesity and MAFLD were more likely to be female, older and exhibit higher prevalence of advanced liver fibrosis (7.421% vs. 2.363%, p < 0.001), type 2 diabetes mellitus (T2DM) (21.484% vs. 8.318%, p < 0.001) and CKD(30.306% vs. 16.068%, p < 0.001) compared to those with MAFLD alone. MAFLD (adjusted OR: 1.392, 95% CI 1.013-1.913, p = 0.041), abdominal obesity (adjusted OR 1.456, 95% CI 1.127-1.880, p = 0.004), abdominal obesity with MAFLD (adjusted OR 1.839, 95% CI 1.377-2.456, p < 0.001), advanced fibrosis(adjusted OR 1.756, 95% CI 1.178-2.619, p = 0.006) and T2DM (adjusted OR 2.365, 95% CI 1.758-3.183, p < 0.001) were independent risk factors of CKD. The abdominal obese MAFLD group had the highest all-cause mortality as well as mortality categorized by disease during the 30-year follow-up period. Indices for measuring abdominal obesity, such as waist circumference (WC), waist-hip ratio (WHR), and lipid accumulation product (LAP), elucidated a greater mediation effect of MAFLD on CKD compared to BMI on CKD (proportion mediation 65.23%,70.68%, 71.98%, respectively vs. 32.63%). In conclusion, the coexistence of abdominal obesity and MAFLD increases the prevalence and mortality of CKD, and abdominal obesity serves as a mediator in the association between MAFLD and CKD.


Assuntos
Obesidade Abdominal , Insuficiência Renal Crônica , Humanos , Feminino , Obesidade Abdominal/complicações , Obesidade Abdominal/epidemiologia , Masculino , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/metabolismo , Insuficiência Renal Crônica/patologia , Estudos Retrospectivos , Pessoa de Meia-Idade , Adulto , Diabetes Mellitus Tipo 2/complicações , Inquéritos Nutricionais , Fatores de Risco , Prevalência , Estados Unidos/epidemiologia , Idoso , Cirrose Hepática/complicações , Cirrose Hepática/metabolismo , Cirrose Hepática/epidemiologia
13.
BMC Med ; 22(1): 230, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38853248

RESUMO

BACKGROUND: Obesity and central obesity are multifactorial conditions with genetic and non-genetic (lifestyle and environmental) contributions. There is incomplete understanding of whether lifestyle modifies the translation from respective genetic risks into phenotypic obesity and central obesity, and to what extent genetic predisposition to obesity and central obesity is mediated via lifestyle factors. METHODS: This is a cross-sectional study of 201,466 (out of approximately 502,000) European participants from UK Biobank and tested for interactions and mediation role of lifestyle factors (diet quality; physical activity levels; total energy intake; sleep duration, and smoking and alcohol intake) between genetic risk for obesity and central obesity. BMI-PRS and WHR-PRS are exposures and obesity and central obesity are outcomes. RESULTS: Overall, 42.8% of the association between genetic predisposition to obesity and phenotypic obesity was explained by lifestyle: 0.9% by mediation and 41.9% by effect modification. A significant difference between men and women was found in central obesity; the figures were 42.1% (association explained by lifestyle), 1.4% (by mediation), and 40.7% (by modification) in women and 69.6% (association explained by lifestyle), 3.0% (by mediation), and 66.6% (by modification) in men. CONCLUSIONS: A substantial proportion of the association between genetic predisposition to obesity/central obesity and phenotypic obesity/central obesity was explained by lifestyles. Future studies with repeated measures of obesity and lifestyle would be needed to clarify causation.


Assuntos
Bancos de Espécimes Biológicos , Predisposição Genética para Doença , Estilo de Vida , Obesidade , Fenótipo , Humanos , Masculino , Feminino , Estudos Transversais , Reino Unido/epidemiologia , Pessoa de Meia-Idade , Obesidade/genética , Obesidade/epidemiologia , Idoso , Adulto , Obesidade Abdominal/genética , Obesidade Abdominal/epidemiologia , Biobanco do Reino Unido
14.
PLoS One ; 19(6): e0305604, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38917085

RESUMO

INTRODUCTION: Obesity is associated with concomitant chronic conditions. An early metabolic consequence of obesity is disruption of glucose and insulin homeostasis. One of the consequences is impaired fasting glucose (IFG). Visceral fat is metabolically more harmful than subcutaneous fat, but few information is available regarding the association between the risk of abnormal glucose in increased waist circumference. METHODS: This study is based on a cross sectional of 1,381 population-based from Palembang, Indonesia. The eligibility requirements subject were to be older than 18 and consent to taking fasting glucose and lipid profile tests as well as physical exams measuring their body weight, height, blood pressure, abdominal circumference, and waist circumference. RESULTS: The number of subjects consisting of 798 noncentral obesity with normoglycemia, 376 central obesity with normoglycemia, and 207 central obesity with concomitant IFG. The prevalence central obesity with concomitant IFG was 35.51%. In subjects with central obesity, there were significant differences in proportions based on sex, age, marital status, education, and occupation. In multivariate analysis show that the risk factors that contribute to having a significant association with central obesity with concomitant IFG are sex (female), age (>40 years), blood pressure (hypertension), and HDL-C <50 mg/dL (p<0.001). The analysis also founded that there was a significant difference in the dietary pattern of sweet foods (p = 0.018), sweet drinks (p = 0.002), soft drinks (p = 0.001) and smoking habit (p<0.001) between subjects with obesity central and concomitant IFG compared to subjects with noncentral obesity. The majority of subjects with obesity central and concomitant IFG had consuming these risky foods >6 times/week. CONCLUSION: The prevalence of central obesity with IFG is quite high. There are significant differences in the characteristics, lipid profile, blood pressure, dietary pattern, and smoking habit of central obesity with concomitant IFG was confirmed in this population-based observational study.


Assuntos
Glicemia , Jejum , Obesidade Abdominal , Humanos , Masculino , Feminino , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Fatores de Risco , Glicemia/análise , Glicemia/metabolismo , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/complicações , Jejum/sangue , Indonésia/epidemiologia , Circunferência da Cintura , Obesidade/complicações , Obesidade/epidemiologia , Prevalência
15.
Int J Med Sci ; 21(8): 1518-1528, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38903920

RESUMO

Close associations among secondhand smoke (SHS) and metabolic syndrome (MetS) and its components have been demonstrated, however sex differences in these associations remain unclear. We collected 121,364 participants from the Taiwan Biobank, and excluded those with smoking history, the remaining 88,297 participants (male: 18,595; female: 69,702; mean age 50.1 ± 11.0 years) were included. SHS exposure was evaluated based on self-reported questionnaires. SHS was associated with MetS (odds ratio [OR], 1.268, p < 0.001 for males vs. 1.180, p < 0.001 for females), abdominal obesity (OR, 1.234, p < 0.001 for males vs. 1.199, p < 0.001 for females), low high-density lipoprotein cholesterol (OR, 1.183, p = 0.008 for males vs. 1.094, p = 0.011 for females), hyperglycemia (OR, 1.286, p < 0.001 for males vs. 1.234, p < 0.001 for females), but not with hypertriglyceridemia. SHS was associated with high blood pressure (BP) (OR, 1.278, p < 0.001) only in males, but not in females. Furthermore, significant interactions were found between sex x SHS on MetS (p = 0.023), abdominal obesity (p = 0.032), and elevated BP (p < 0.001). Moreover, the participants who were exposed to SHS for ≥1 hour per week were associated with a higher risk (OR = 1.316, p = 0.001 in males vs. OR = 1.220, p < 0.001 in females) of MetS compared to those with no exposure. These results showed an association between SHS and a high OR for MetS in both the males and females. Furthermore, sex differences were identified in the associations between SHS and MetS and its components, and SHS was more closely related to MetS, abdominal obesity, and high BP in males than in females.


Assuntos
Síndrome Metabólica , Poluição por Fumaça de Tabaco , Humanos , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Masculino , Feminino , Taiwan/epidemiologia , Pessoa de Meia-Idade , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Adulto , Fatores Sexuais , Seguimentos , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/complicações , não Fumantes/estatística & dados numéricos , Fatores de Risco , Idoso
16.
Sci Rep ; 14(1): 14230, 2024 06 20.
Artigo em Inglês | MEDLINE | ID: mdl-38902300

RESUMO

Over the years, obesity has become more commonplace and has had a substantial impact on several medical specialties, including reproductive medicine. The potential correlation between the visceral adiposity index (VAI) and infertility has yet to be determined. Women between the ages of 18 and 45 were included in this cross-sectional study, which was conducted as part of the National Health and Nutrition Examination Survey (NHANES) between 2015 and 2020. Three tertiles were used to group VAI levels. Subgroup analysis and weighted binary logistic regression were employed to investigate the independent relationship between VAI and infertility. Smooth curve fitting was used to explore nonlinear relationships. This cross-sectional study followed the criteria of the STROBE guidelines. Of the 1231 participants, 127 were infertile women aged 18-45 years. A higher VAI was associated with a higher prevalence of infertility (OR = 1.22, 95% CI:1.03-1.45), which remained consistent across all subgroups (p > 0.05 for all interactions). We demonstrated a positive nonlinear association between VAI and infertility using a smooth curve fit. A higher visceral adiposity index level is positively correlated with a higher incidence of infertility among women in the United States. Women who are infertile can be identified using the visceral obesity index, and controlling visceral obesity may help lower the chances of becoming infertile.


Assuntos
Infertilidade Feminina , Inquéritos Nutricionais , Obesidade Abdominal , Humanos , Feminino , Adulto , Estados Unidos/epidemiologia , Infertilidade Feminina/epidemiologia , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/complicações , Obesidade Abdominal/fisiopatologia , Estudos Transversais , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Adiposidade , Prevalência , Gordura Intra-Abdominal , Índice de Massa Corporal
17.
BMC Womens Health ; 24(1): 315, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38824522

RESUMO

BACKGROUND: Sleep health and obesity may affect the risk of female infertility. However, few studies focused on the interaction of obesity and sleep health on the female infertility risk. This study aimed to evaluate the combined impact of trouble sleeping / sleep duration and overweight/obesity/ abdominal obesity on the risk of female infertility. METHODS: The data for this cross-sectional study was obtained from National Health and Nutritional Examination Survey, which provided information on trouble sleeping, sleep duration, overweight/obesity, abdominal obesity, and confounding factors. Adopted weighted univariate and multivariate logistic regression models to explore the relationship between trouble sleeping, sleep duration, overweight/obesity, abdominal obesity, and the risk of infertility, respectively, and the combined effect of trouble sleeping and overweight/obesity, trouble sleeping and abdominal obesity, sleep duration and overweight/obesity, sleep duration and abdominal obesity, on the female infertility risk. RESULTS: This study included a total of 1,577 women, and 191 were diagnosed with infertility. Women with infertility had a higher proportion of people with overweight/obesity, abdominal obesity, sleep duration ≤ 7 h and trouble sleeping than those with non-infertility. The result indicated that trouble sleeping [odds ratio (OR) = 2.25, 95% confidence intervals (CI): 1.49-3.39], sleep duration ≤ 7 h (OR = 1.59, 95% CI: 1.03-2.48), and the combined impact of abdominal obesity and trouble sleeping (OR = 2.18, 95% CI: 1.28-3.72), abdominal obesity and sleep duration ≤ 7 h (OR = 2.00, 95% CI: 1.17-3.40), overweight/obesity and trouble sleeping (OR = 2.29, 95% CI: 1.24-4.26), and overweight/obesity and sleep duration ≤ 7 h (OR = 1.88, 95% CI: 1.01-3.49) were associated with increased odds of infertility, respectively. CONCLUSION: There was combined effects of trouble sleeping/sleep duration ≤ 7 h and overweight/obesity/ abdominal obesity on increased odds of female infertility.


Assuntos
Infertilidade Feminina , Inquéritos Nutricionais , Obesidade Abdominal , Obesidade , Transtornos do Sono-Vigília , Humanos , Feminino , Adulto , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/etiologia , Estudos Transversais , Obesidade/epidemiologia , Obesidade/complicações , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/complicações , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/complicações , Sono/fisiologia , Sobrepeso/epidemiologia , Sobrepeso/complicações , Fatores de Risco , Adulto Jovem , Estados Unidos/epidemiologia
18.
Cardiovasc Diabetol ; 23(1): 201, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38867282

RESUMO

BACKGROUND: It's unclear if excess visceral adipose tissue (VAT) mass in individuals with prediabetes can be countered by adherence to a Mediterranean lifestyle (MEDLIFE). We aimed to examine VAT mass, MEDLIFE adherence, and their impact on type 2 diabetes (T2D) and diabetic microvascular complications (DMC) in individuals with prediabetes. METHODS: 11,267 individuals with prediabetes from the UK Biobank cohort were included. VAT mass was predicted using a non-linear model, and adherence to the MEDLIFE was evaluated using the 25-item MEDLIFE index, encompassing categories such as "Mediterranean food consumption," "Mediterranean dietary habits," and "Physical activity, rest, social habits, and conviviality." Both VAT and MEDLIFE were categorized into quartiles, resulting in 16 combinations. Incident cases of T2D and related DMC were identified through clinical records. Cox proportional-hazards regression models were employed to examine associations, adjusting for potential confounding factors. RESULTS: Over a median follow-up of 13.77 years, we observed 1408 incident cases of T2D and 714 cases of any DMC. High adherence to the MEDLIFE, compared to the lowest quartile, reduced a 16% risk of incident T2D (HR: 0.84, 95% CI: 0.71-0.98) and 31% for incident DMC (0.69, 0.56-0.86). Conversely, compared to the lowest quartile of VAT, the highest quartile increased the risk of T2D (5.95, 4.72-7.49) and incident any DMC (1.79, 1.36-2.35). We observed an inverse dose-response relationship between MEDLIFE and T2D/DMC, and a dose-response relationship between VAT and all outcomes (P for trend < 0.05). Restricted cubic spline analysis confirmed a nearly linear dose-response pattern across all associations. Compared to individuals with the lowest MEDLIFE quartile and highest VAT quartile, those with the lowest T2D risk had the lowest VAT and highest MEDLIFE (0.12, 0.08-0.19). High MEDLIFE was linked to reduced T2D risk across all VAT categories, except in those with the highest VAT quartile. Similar trends were seen for DMC. CONCLUSION: High adherence to MEDLIFE reduced T2D and MDC risk in individuals with prediabetes, while high VAT mass increases it, but MEDLIFE adherence may offset VAT's risk partly. The Mediterranean lifestyle's adaptability to diverse populations suggests promise for preventing T2D.


Assuntos
Diabetes Mellitus Tipo 2 , Angiopatias Diabéticas , Dieta Mediterrânea , Gordura Intra-Abdominal , Estado Pré-Diabético , Fatores de Proteção , Comportamento de Redução do Risco , Humanos , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Gordura Intra-Abdominal/fisiopatologia , Idoso , Fatores de Risco , Medição de Risco , Angiopatias Diabéticas/epidemiologia , Angiopatias Diabéticas/diagnóstico , Angiopatias Diabéticas/prevenção & controle , Fatores de Tempo , Incidência , Adiposidade , Reino Unido/epidemiologia , Adulto , Dieta Saudável , Exercício Físico , Estilo de Vida Saudável , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/fisiopatologia , Estudos Prospectivos
19.
Nutrients ; 16(11)2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38892518

RESUMO

There is currently no available information on the correlation between abdominal obesity indices and the risk of liver fibrosis progression. We aimed to investigate the relationship between the body mass index (BMI), waist circumference (WC), and the visceral adiposity index (VAI) with the progression of liver fibrosis. The study also evaluated the association between these indices and the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis. A total of 1403 subjects participated in the cross-sectional and longitudinal population-based study. Liver stiffness was assessed via transient elastography, at baseline and follow-up (median: 4.2 years). The subgroup with dysglycemia was also analyzed. In the cross-sectional study, the highest quartile of VAI, BMI ≥ 30 kg/m2, and abdominal obesity showed significant associations with the prevalence of MASLD and liver fibrosis, as well as with fibrosis progression. However, VAI showed no association with MASLD incidence. Among the dysglycemic subjects, there was no observed association between VAI and the incidence of MASLD or the progression of fibrosis. In conclusion, the BMI, WC, and the VAI are associated with an increased risk of progression to moderate-to-advanced liver fibrosis in the general population. However, the VAI does not perform better than the BMI and WC measurement.


Assuntos
Índice de Massa Corporal , Progressão da Doença , Cirrose Hepática , Obesidade Abdominal , Circunferência da Cintura , Humanos , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/complicações , Masculino , Cirrose Hepática/epidemiologia , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Adulto , Estudos Longitudinais , Prevalência , Fatores de Risco , Gordura Intra-Abdominal , Idoso
20.
Beijing Da Xue Xue Bao Yi Xue Ban ; 56(3): 418-423, 2024 Jun 18.
Artigo em Chinês | MEDLINE | ID: mdl-38864126

RESUMO

OBJECTIVE: To explore the relationship between puberty timing and cardiovascular metabolic risk factors among primary and secondary students with different genders in Beijing. METHODS: Using the method of stratified cluster sampling by urban and rural areas and school sections, 3 067 students from 16 primary and secondary schools in Fangshan District of Beijing were selected in October 2012, with questionnaire survey, physical examination and serum laboratory testing. In this study, we controlled for confounding factors such as school segments, current residence of the family, birth weight, feeding method, only child, highest educational level of parents, and monthly family income, and then the associations between cardiovascular metabolic risk factors and puberty timing among the primary and secondary students was analyzed by multivariate Logistic analysis. To ensure the reliability of the data, this study adopted strict quality control. RESULTS: A total of 3 067 primary and middle school students aged 7 to 16 years were included in this study, including 1 575 boys and 1 492 girls. The prevalence of premature puberty was 14.73% among the boys and 12.89% among the girls, respectively. The prevalence of delayed puberty was 9.49% among the boys and 10.99% among the girls, respectively. The detection rates of central obesity, hypertension, hyperglycemia, and dyslipidemia among the primary and secondary students were 35.87%, 19.95%, 2.54% and 26.31%, respectively. The detection rates of 1 risk factor clustering, 2 risk factors clustering and more than 3 risk factors clustering were 29.21%, 16.17% and 9.36%, respectively. The difference in the detection rate of cardiovascular and metabolic risk factors in different youth stages was insignificant (P>0.05), the detection rate of risk factor aggregation of 0 was lower than that of the timely group and delayed group, and the detection rate of risk factors aggregation of 2 was higher than that of the timely group (P < 0.05).After adjusting the effects of learning stage, region, birth weight, feeding patterns, one-child, family income and the parents' educational levels, multivariate Logistic regression analysis showed that, compared with the on-time puberty group, the risk of 1 risk factor clustering, 2 risk factors clustering and more than 3 risk factors clustering increased by 1.94 times (95% CI=1.29-2.91), 2.97 times (95% CI=1.89-4.67) and 2.02 times (95% CI= 1.13-3.63) among the girls; It had not been found that the relationship between puberty timing and cardiovascular risk factor clustering among the boys (P>0.05). CONCLUSION: Premature puberty is an independent risk factor for the clustering of cardiometabolic risk factors in girls, and primary prevention strategies should be implemented to reduce the burden of cardiovascular metabolic diseases in the population.


Assuntos
Doenças Cardiovasculares , Puberdade , Estudantes , Humanos , Feminino , Masculino , Adolescente , Criança , China/epidemiologia , Estudantes/estatística & dados numéricos , Puberdade/fisiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Fatores de Risco , Inquéritos e Questionários , Fatores de Risco de Doenças Cardíacas , Hipertensão/epidemiologia , Dislipidemias/epidemiologia , Puberdade Precoce/epidemiologia , Obesidade Abdominal/epidemiologia , Prevalência , Hiperglicemia/epidemiologia , Fatores Etários
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