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Body mass index metabolic syndrome: Asian Americans have greater prevalence of metabolic syndrome despite lower body mass index

Multivariable models predicting incident diabetes included covariates for age, sex, parental history of diabetes, and impaired glucose tolerance.

William Murphy
Saturday, August 6, 2016
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  • A similar pattern was observed in disaggregated Asian subgroups.

  • ISBN Bubnis D ed.

  • Diabetes Care ; 28 —7.

  • Washington, DC : U.

Introduction

Can body mass index, waist circumference, waist-hip ratio and waist-height ratio predict the presence of multiple metabolic risk factors in Chinese subjects? Peter W. See Medicine Baltimore. Metabolic syndrome was identified based on 3 traits in N Engl J Med.

  • Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. Vasan, David M.

  • Meigs JB Metabolic syndrome: in search of a clinical role.

  • Cardiovascular risk factors in confirmed prediabetic individuals.

Skip directly to site content Skip directly to page options Skip directly to A-Z link. Adolphe Queteleta Belgian astronomer, mathematician, statistician, and sociologist, devised the basis of the BMI between and as he developed what he called "social physics". BMIs under 20 and over 25 have been associated with higher all-causes mortality, with the risk increasing with distance from the 20—25 range. Durward et al found that only obese adults with MetS had a higher hazard ratio compared with the normal-weight—no-MetS group

Between and the U. This is the latest accepted revisionreviewed on 2 August Conversely, large framed or tall individuals may be quite healthy, with a fairly inxex body fat percentagebut be classified as overweight by BMI. We did not conduct sex-specific analyses because there were too few events in some subgroups to calculate stable risk estimates. View Metrics. Subjects and Methods. Apparently healthy obese subjects may have subclinical vascular disease 4243 so that longer follow-up or more careful evaluation of vascular phenotypes may be required for MHO-like subjects to develop adverse health outcomes, including those not considered in this analysis 2.

Associated Data

Figure 1. Predicting cardiometabolic risk: waist-to-height ratio or BMI. A meta-analysis.

The results were considered as statistically significant at. MetS b 9. This study is part of a larger project assessing health in ageing women. Characteristics of patients from the study groups with IFG and without carbohydrate disorders. Soc Sci J.

Our study, however, has some limitations; first, it was done on a specific group—Israeli adults who visited the RPEI during study years. Keywords: abdominal obesity, BMI, metabolic syndrome, waist circumference. Lancet ; : — Aging of skeletal muscle: a yr longitudinal study. Am J Clin Nutr 81 : —

International Scholarly Research Notices

Because of the large number of normal-weight adults with metabolic syndrome at the population level, to prevent premature mortality, greater attention must be given to diagnosing and proactively treating metabolic syndrome in these normal-weight adults. Circulation : 42 — Many researchers argue that BMI is not a good indicator of weight status, because it does not differentiate among body compositions 26,

Am J Epidemiol ; : index metabolic syndrome Table 4 presents the statistically significant differences between the group of patients with arterial hypertension and the group of patients with normal arterial blood pressure. Dekker, C. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Variability in waist circumference measurements according to anatomic measurement site. We concluded that BMI can serve as a good survey for the primary physician.

Other studies concluded that BMI can predict the presence of multiple metabolic risk factors [ 29 ]. It furthers the University's objective of excellence in research, scholarship, and bbody by publishing worldwide. Overweight, obesity, MetS, or IR all increased the multivariable RR for incident diabetes by approximately 5- to 7-fold relative to those without these conditions Table 3. Our findings in Asian populations in the United States corroborate this increased disease risk for metabolic syndrome at lower BMI. However, there was no significant difference in the prevalence of metabolic risk factors between BMI and FMI-obesity categories indicating that fat location may influence metabolic dysregulation.

Conversely, large framed or tall individuals may be quite healthy, with a fairly low body fat percentagebut be classified as overweight by BMI. Index metabolic syndrome, Ramachandran S. Washington, DC : U. National Institutes of Health Massswaist circumference in excess of 1, mm 40 in for men and mm 35 in for non-pregnant women is considered to imply a high risk for type 2 diabetes, dyslipidemiahypertension, and CVD. Environment International. Groups with MetS were generally older, less educated, and less physically active and had a lower income and a higher prevalence of smoking than their no-MetS counterparts Table 1. Assumptions about the distribution between muscle mass and fat mass are inexact.

1. Introduction

Medical News Today. What is syyndrome by this report? Ruderman and others 4 — 8 identified metabolically obese normal-weight MONW individuals who, despite having a normal-weight BMI, demonstrate metabolic disturbances typical of obese individuals. CDC is not responsible for Section compliance accessibility on other federal or private website. Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men.

Because of the large number of normal-weight adults with metabolic syndrome at the population level, to prevent premature mortality, greater attention must be given to diagnosing and proactively treating metabolic syndrome in these normal-weight adults. Ann Intern Med : — Similarly, this is becoming more and more pertinent to the growth of children, since the majority of children are sedentary. A useful method for assessing metabolic health is to determine the presence of metabolic syndrome MetSwhich is defined as having 3 of the following 5 criteria: central obesity, elevated blood glucose, elevated triglycerides, low levels of high-density lipoprotein cholesterol, and elevated blood pressure 4. The differences in the results of our study and the results of those studies may be due to several factors.

Nonetheless, body mass index metabolic syndrome data demonstrate that the presence of metabolic risk defined either by risk factor clusters or IR identifies BMI subphenotypes with substantially different levels of risk for consequences traditionally considered to have a simple dose-response relationship with increasing BMI. European Journal of Epidemiology. Metabolic syndrome in normal-weight Americans: new definition of the metabolically obese, normal-weight individual. Figure 1. In addition, we had limited statistical power in the obese-without MetS group to detect small differences. So, if all body dimensions double, and mass scales naturally with the cube of the height, then BMI doubles instead of remaining the same. The medical establishment [46] and statistical community [47] have both highlighted the limitations of BMI.

  • Metabolic syndrome is a constellation of multiple metabolic risk factors that greatly increases risk for cardiovascular mortality 1 and type 2 diabetes.

  • Waist-to-hip circumference ratio has also been used, but has been found to be no better than waist circumference alone, and more complicated to measure. BMI was designed to be used as a simple means of classifying average sedentary physically inactive populations, with an average body composition.

  • Am J Clin Nutr 34 : — Barberger-Gateau et al.

  • The analysis included 12, adults.

  • Accurate obesity classification is important so that appropriate intervention can be instituted to modify metabolic risk factors.

Archived from the original on 18 December Olympia Ronnie Coleman was Article Navigation. Risk factors for coronary artery disease in healthy persons with hyperinsulinemia and normal glucose tolerance. The prevalence of MetS was Liver Transplantation.

Although obesity is a known, common risk factor for MetS, Sjndrome in the normal-weight population is syndrome due to factors independent of obesity. The optimal BMI was found to be in the range of Conclusions: These results demonstrate that metabolic syndrome is prevalent and that it increases with age and with BMI. Although body mass index values were lower than the international cut-offs, these values were good predictors of some metabolic abnormalities in Syrian adolescents; body mass index is a good predictor of these abnormalities in this population.

Publication types

In this paper, Keys argued that what he termed the BMI ibdex " Sports Nutrition. We focused on people with normal weight and MetS. The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U. Another limitation is that we lacked data from longitudinal time points.

J Clin Endocrinol Metab 89 : — ABC News. Body mass index BMI has consistently been associated with adverse health outcomes, but subphenotypes of obesity have been recognized that appear to deviate from the apparent dose-response relationship between BMI and its consequences. Other studies that examined groups of people of primarily European descent stratified by BMI and metabolic health criteria — usually MetS or insulin resistance — found similarly higher risks for cardiovascular disease and diabetes in the normal-weight but metabolically unhealthy group 6—11whereas 2 other studies found contradictory results 28, Skip directly to site content Skip directly to page options Skip directly to A-Z link. No MetS. The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.

Overall, of subjects, 2. We then excluded participants if they had BMI less than Niger J Health Sci. The obese with MetS phenotype accounted for Journal of Chronic Diseases. This is the latest accepted revisionreviewed on 2 August

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Each patient file was scanned to determine if they fulfil the American Heart Association criteria for metabolic syndrome. However, BMI is limited sndrome the inability of the weight numerator to distinguish between the contribution from fat and soft tissue lean mass, the latter of which includes muscle tissue [ 1 ]. Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity.

Based on receiver operating characteristics calculation for body mass index and some metabolic metaboluc, the data suggest the best body mass index cut-offs ranged between Kuk and Ardern included 6, participants, and the Durward et al study included 4, participants, of whom only 77 were in the normal-weight—MetS group. Abbreviation: MetS, metabolic syndrome. Body mass index and blood pressure were measured.

On the contrary, the large number of patients allowed us to achieve statistical significance for our findings. A total of white women were stratified into 4 age groups by decades; 40—49, 50—59, 60—69 and 70—79 years. Gallagher et al. In particular, the under-classification of obesity with BMI is higher in the overweight category due to its inability to differentiate between fat mass and lean mass compared to FMI. In the obese-without MetS phenotype, in particular, measurement of subclinical inflammation, endothelial dysfunction, or adiponectin 13434748 might reveal less than perfect metabolic health. Reaven G. Detailed demographic characteristics for the cohort were not available to provide further controls for this analysis.

Rights and permissions Reprints and Permissions. Yajnik CS. Accurate and early diagnosis of overweight and obesity in Asian Americans metabolic syndrome critical to stem the rising tide of metabolic syndrome and type 2 diabetes in this rapidly growing population within the United States. Where should we measure waist circumference in clinically overweight and obese youth? Overall prevalence. A total of subjects provided data for the present analysis, after exclusion of with diabetes or CVD at the baseline exam, and with missing baseline BMI or MetS characteristics.

Subjects and Methods

Fitness alters the associations of BMI and waist circumference with total and abdominal fat. The definition of increased waist metagolic WCas part of metabolic syndrome diagnosis, requires the use of sex and ethnic specific values, and is less intuitive, hence not used in common practice. Therefore, the purpose of this study was to determine the relationship between obesity as determined by BMI and the major metabolic risk factors among Syrian adolescents.

Dietary intake was evaluated, and the multiple source methods program was applied. International Journal of Epidemiology. Overweight or obese subjects without MetS and overweight, insulin-sensitive subjects were not at increased risk for diabetes. Overweight females were more than five times as likely and obese females were more than 17 times as likely as normal weight females to meet the criteria.

Eligibility was restricted to women who were ambulatory or able to be transported and those available and metaolic to undergo the clinical assessments and to provide informed consent. The advantage of FMI is that this metric is not confounded by lean mass. Conversely, individuals with high amount of lean mass, that is, large muscle bulk, would be incorrectly classified with obesity. Likewise, among overweight subjects, the cumulative incidence was 4. The study group consisted of patients with diagnosed metabolic syndrome: men Search Search articles by subject, keyword or author. Volume

In addition, we had limited metabolkc power in the obese-without MetS group to detect small differences. Editor: Frank T. First, we sought to compare the age-adjusted prevalence rates of metabolic syndrome across different Asian subgroups and BMI categories compared with NHWs. Interpretation of low body mass indices: Australian aborigines. What are the physical characteristics associated with a normal metabolic profile despite a high level of obesity in postmenopausal women? Overall, of subjects, 2.

Subjects and Methods

The interpretation that obese subjects without MetS are really obese and healthy needs to be made with caution, however. Increased visceral adipose tissue accumulation is more strongly associated with risk of metabolic disorders than subcutaneous adipose tissue because of its location in the abdominal cavity and its large role in endocrine and inflammatory secretion Males 60 years of age and over were more than four times as likely and females 60 years of age and over were more than six times as likely as the youngest age group to meet the criteria. Colours indicate BMI categories defined by the World Health Organization; underweightnormal weightoverweightmoderately obeseseverely obese and very severely obese.

Eur J Cardiovasc Prev Rehabil ; 18 — Published online Jun Obes Res ; 10 : — Therefore, there is a greater issue with lower test sensitivity for diagnosis of obesity using BMI at

Perhaps the greater significance of the prevalence of the obese-without MetS phenotype is its converse—that synvrome overweight and obese individuals are metabolically high risk and at substantially elevated risk for diabetes or CVD. Archived from the original on 1 May This became the definitive guide for determining if someone is overweight. Parental transmission of type 2 diabetes mellitus: the Framingham Offspring Study. In the presence of the metabolic consequences of obesity, increasing levels of overall obesity added incremental risk for type 2 diabetes, although not for CVD.

  • However, many studies have shown that CVDs occur more frequently at lower BMI in Asian than European populations, the mechanisms involved are yet to be demonstrated.

  • Chart showing body mass index BMI for a range of heights and weights in both metric and imperial.

  • An investigation of coronary heart disease in families: the Framingham Offspring Study. Therefore, it is very important to develop an effective screening tool of MetS and its individual components, and analyze their association with overweight and obesity.

  • Interestingly, obese, insulin-sensitive subjects were at about 3-fold increased risk of diabetes relative to normal-weight subjects without IR, suggesting that obesity is diabetogenic even in the absence of IR. Obese subjects with MetS had an adjusted relative risk for diabetes of

Clinical history was collected including hypertension, diabetes, dyslipidemia, and cardiovascular mrtabolic diabetic medications. The definition of increased waist circumference WCas part of metabolic syndrome diagnosis, requires the use of sex and ethnic specific values, and is less intuitive, hence not used in common practice. What This Study Adds among anthropometric indices, BMI offers the highest negative predictive value to rule out metabolic syndrome. Journal of applied physiology Bethesda, Md: BMI under-classified obesity in the overweight category by

We observed in our community-based sample that there were small numbers body mass index men and women with normal weight who had MetS or IR, bodu the MONW phenotype described by Ruderman and others 4 — 8 and modest numbers with obesity but without MetS or IR, resembling the MHO phenotype described by Brochu, Karelis, and others 10 — Abstract Objective: The purpose of this study was to examine the prevalence of individual risk factors for metabolic syndrome as well as the prevalence of metabolic syndrome in the National Health and Nutrition Examination Survey NHANES Archived PDF from the original on Samaras TT, ed. In a subsidiary analysis that excluded all cases of incident diabetes occurring over follow-up, associations of obesity and MetS or IR with incident CVD remained very similar.

McLaughlin T metabolic syndrome, Allison GAbbasi FLamendola CReaven G Prevalence of insulin resistance and associated cardiovascular disease risk factors among normal weight, overweight, and obese individuals. Hyperinsulinemia, hyperglycemia, and impaired hemostasis: the Framingham Offspring Study. Objective: The objective of this study was to assess risk for diabetes or cardiovascular disease CVD stratified by body mass index BMI and the presence or absence of metabolic syndrome MetS or insulin resistance IR. Telephone:

Impact of the metabolic syndrome on mortality from lndex heart disease, cardiovascular disease, and all causes in United States adults. Am J Hum Biol. Predicting cardiometabolic risk: waist-to-height ratio or BMI. Due to the limitations of BMI methodology, current reports by the World Health Organization and other organizations suggest combining the measurements of BMI and abdominal obesity [ 11 ].

A question to metaholic is whether a revision of the current BMI-based obesity criteria should be made or whether using those criteria in the assessment synrdome abdominal obesity should be abandoned. Discussion Identification of an accurate method to diagnose obesity is important so that appropriately targeted intervention strategies such as dietary education and control, physical activity programmes, pharmacotherapy and bariatric surgery can be instituted to modify the associated metabolic and atherosclerotic risk factors [ 29 ]. This study results may be influenced by selection bias, as attendants of the periodic examination institute are probably more aware of their health. There is much evidence that obesity among adolescents contributed significantly to the development of type 2 diabetes and coronary heart disease in adulthood. The BMI as single survey measurement of obesity offers high NPV for metabolic syndrome and can be used by physician and patients for this purpose. Current consensus definition: prevalence, etiology, and consequences.

Dekker, C. Circulation ; — Diabetes 48 : — J Am Med Dir Assoc. Comparison of body mass index and waist circumference as predictors of cardiometabolic health in a population of young Canadian adults.

Obese adolescents had higher abdominal fat, which metabollic body mass index metabolic syndrome with cardiometabolic alterations such as LDL-Chol, increased triglycerides and LDL-Chol, and increased blood pressure, resulting in increased risk for CVD [ 22 ]. Grundy, and P. Clinical correlates and heritability of flow-mediated dilation in the community: the Framingham Heart Study. Not surprisingly, as WC is part of the diagnostic criteria for metabolic syndrome, it had the highest PPV for metabolic syndrome among all anthropometric indices we examined. Am J Epidemiol ; : — For diabetes or impaired fasting glucose, Asians had uniformly higher predicted prevalence than NHWs across all BMI values in women and men.

World Health Organization technical report series. Table 1 Baseline characteristics of body mass index and biochemical variables metabollc Syrian adolescents 18 to 19 years. Subjects with the MHO-like phenotype did not appear to be at significantly increased risk for CVD and were at lesser risk for diabetes. Google Scholar Crossref. View Article Google Scholar 3. BMC Public Health. Accurate obesity classification is important so that appropriate intervention can be instituted to modify metabolic risk factors.

Because of this, the standards have varied over the past few decades. Results: 61 women were included. Other important risk jass such as blood pressure, cholesterol, and blood glucose were already included in the definition of MetS. Although metabolic syndrome MetS is less prevalent among normal-weight adults than among overweight and obese adults, it does occur. Conversely, large framed or tall individuals may be quite healthy, with a fairly low body fat percentagebut be classified as overweight by BMI. No MetS. When the term BMI is used informally, the units are usually omitted.

In our cohort, we found similarity in the prevalence of metabolic syndrome in men and women, and similar mean stndrome of men and women with metabolic syndrome men Received Feb 16; Accepted May 3. Yajnik CS. Palaniappan, L. Assuming FMI as the reference standard based on its sole metric of fat uninfluenced by lean mass, BMI over-classified 3.

Fam Pract ; 26 — Table 1 Demographics and mass medical history of patients with and without metabolic syndrome, by sex. A fat mass index was used in screening for the presence of MetS [ 3 ]. Consent for publication Not applicable. Women with metabolic syndrome had higher proportion of obesity, when compared with men

We conducted a subsidiary analysis of CVD obesity that excluded incident cases of diabetes to ensure that risk was not a function of the concurrent development of diabetes. A better measure was found to be the waist-to-height ratio. Carl Lavie has written that "The B. The location of adipose tissue can also affect metabolic health. Article Contents Abstract. Open in new tab Download slide. BMI Prime is a dimensionless number independent of units.

MeSH terms

Published online Mar 1. External link. The cluster of risk factors for atherosclerotic disease and type 2 diabetes which includes hypertension, dyslipidaemia raised triglycerides and lowered high density lipoprotein cholesterolraised fasting glucose and central obesity is known as the metabolic syndrome [ 3 ].

Volume Diabetes 47 : — Our findings have one apparent clinical implication. Accuracy of bpdy reports of parental cardiovascular disease history: the Framingham Offspring Study. Although obesity and MetS are related, several subsets of people who have a body mass index BMI within the normal range meet the criteria for MetS 3. NHANES collects data for people older than 85 but does not report these extreme values to protect privacy. Meigs, Peter W.

  • Multivariable models predicting incident diabetes included covariates for age, sex, parental history of diabetes, and impaired glucose tolerance. Diabetes 34 : —

  • The adjusted Cox regression model for cardiovascular mortality showed a significant hazard ratio only for the normal-weight—MetS group HR, 2.

  • Overweight conferred risk intermediate between that of normal weight and obesity but only increased risk in the presence of MetS or IR.

  • Circulation : — Further investigation into this theme is needed.

Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Figure 1. Sign In. Conclusions: A strong association between overweight and obesity as determined by body mass index and high concentrations of metabolic syndrome components has been demonstrated.

Table 3. Accepted 30 Dec Discussion Obesity, as measured by BMI, is a well-known risk factor for metabolic syndrome. Close mobile search navigation Article Navigation. Received : 19 April Relationships of H.

Lottenberg, M. MeigsJames B. Arab J Med. We included any adult patient who underwent medical testing at the RPEI.

This had the effect of redefining approximately 29 million Americans, previously healthyto overweight. Authority control. Many researchers argue that BMI is not a good indicator of weight status, because it does not differentiate among body compositions 26, Preventing Chronic Disease. Diabetes 54 : —

Among normal-weight subjects, there were 17 incident diabetes and 63 first CVD events, giving cumulative incidence syjdrome 1. Obesity-associated morbidity. The BMI is a convenient rule of thumb used to broadly categorize a person as underweightnormal weightoverweightor obese based on tissue mass musclefat, and bone and height. The metabolic syndrome: time for a critical appraisal Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Conclusions: These results demonstrate that metabolic syndrome is prevalent and that it increases with age and with BMI. United States Latvia Poland. A BMI that is less than the 5th percentile is considered underweight and above the 95th percentile is considered obese.

  • Diabetes Care ; 25 : —

  • The exponent in the denominator of the formula for BMI is arbitrary.

  • Abstract The aim of the study was to assess whether body mass index BMI can be used as a simple and reliable survey test for metabolic syndrome.

  • Article Contents Abstract. The measure WHtR seems to be a good predictor of cardiometabolic risk, mainly in the Asian population.

  • Archived from the original on 21 August

Table 2 Characteristics of patients with metabolic syndrome, by sex. Age stratified random samples of women in the body mass index metabolic syndrome groups 40—49 years, 50—59 years, 60—69 years and 70—79 years were recruited. Body mass index and blood pressure were measured. View Article Google Scholar 3. Metabolism 53 : — Over a mean of 7-yr follow-up, subjects developed type 2 diabetes, and over a mean of yr follow-up, experienced a first CVD event, giving an overall cumulative incidence of 4.

Overweight and obesity as determinations of cardiovascular risk: the Framingham experience. Our overall prevalence of metabolic syndrome was low at mas Inclusion—exclusion A cross-sectional sample of patient electronic health records from 1 January to 31 December was studied. Am J Public Health 88 : 15 — Waist circumferences abnormal above 40 inch for men or 35 for womenand also BMI abnormal above 25WHR abnormal above 0. Using ROC curves, we tried to find the ideal BMI to identify metabolic syndrome, which was found to be 27 for the entire cohort, for men and for women. Using BMI,

Characteristics of patients from the study groups with and without diabetes mellitus type 2. The correlation coefficient is the lowest in the subgroup of women with diagnosed metabolic syndrome including arterial hypertension. Obesity is related to metabolic disturbances such as insulin resistance and dyslipidaemia, leading to disorders such as diabetes, hypertension and atherosclerotic disease. Besides, its value is affected by sex, age, constitution, and training.

  • Metabolic syndrome across Europe: different clusters of risk factors.

  • Archived from the original on November 22, The data are compiled through surveys using interviews, physical examinations, and laboratory results.

  • Ethnic and racial differences in body composition and fat distribution have been studied. Obesity has nearly tripled worldwide since [ 1 ].

  • Four, we used a more stringent definition of MetS than Kuk and Ardern used. MetS is a risk factor for mortality among normal-weight and obese adults.

Bioinformation ; 8 —6. The obese with MetS phenotype accounted for Metabloic JB Metabolic syndrome: in search of a clinical role. Eur J Epidemiol. Interventions aimed at increasing physical activity and improving diet are cost effective for reducing the risk of diabetes and CVDs associated with obesity. Current consensus definition: prevalence, etiology, and consequences.

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Boddy concentrations of glucose, triglycerides, total cholesterol, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol were determined. Apparently healthy obese subjects may have subclinical vascular disease 4243 so that longer follow-up or more careful evaluation of vascular phenotypes may be required for MHO-like subjects to develop adverse health outcomes, including those not considered in this analysis 2. Open in new tab. Pediatric nephrology Berlin, Germany. Prevalence of metabolic syndrome and its components based on a harmonious definition among adults in Morocco. J Clin Invest : —

The correlation coefficient is the lowest in the subgroup of women with diagnosed metabolic syndrome including metabolic syndrome hypertension. Ethics approval and consent to participate The study protocol was approved by the scientific research and the ethical committee of the AECS, P. Serum insulin, obesity, and the incidence of type 2 diabetes in black and white adults: the atherosclerosis risk in communities study: S1 Appendix. Availability of data and materials Please contact author for data requests. Background According to the estimates of the World Health Organization WHOobesity has become a serious epidemic health problem in many parts of the world, estimated to be the fifth leading cause of mortality at a global level, causing approximately 2. Sign In or Create an Account.

Keywords: abdominal obesity, BMI, metabolic syndrome, waist circumference. We have considered different endpoints to our study; the character of our study did not enable us to use mortality as the endpoint. Table 7.

S2CID Durward et al found that only obese adults with MetS had a higher hazard ratio compared with the normal-weight—no-MetS group Olympia Ronnie Coleman was These weights, strata, and cluster variables were included in all analyses and allow our results to be generalizable to the US population.

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Samaras TT, ed. Diabet Med 16 : — The values indicating increased risk are: greater than 0. Archived PDF from the original on The final analytic sample of 12, participants aged 20 to 85 had data for all variables examined in our study, eligible follow-up mortality data, and no preexisting frailty. United States Latvia Poland.

Obesity, fat distribution, and weight index metabolic syndrome as risk factors for clinical diabetes metabooic men. Table 2 Patient characteristics Full size table. Group with hypertension. Detailed demographic characteristics for the cohort were not available to provide further controls for this analysis. An investigation of coronary heart disease in families: the Framingham Offspring Study. Forum Nutr ; 56 : — View at: Google Scholar A.

The Institutional Review Board of Boston University approved the study protocol, and all subjects gave informed consent at each examination. Lottenberg, M. Youden index was used for describing the best cut-off for identification.

J Clin Endocrinol Metab. View Article Google Scholar Obesity prevalence for each method was determined for the total cohort and each of the age decades. Thank you for visiting nature.

Harvard School of Public Health. Article Contents Abstract. We used a definition of metabolic risk restricted to traditional diabetes or CVD risk factors. Waist circumference is a good indicator of visceral fatwhich poses more health risks than fat elsewhere. Multivariable models predicting incident diabetes included covariates for age, sex, parental history of diabetes, and impaired glucose tolerance. Perhaps the greater significance of the prevalence of the obese-without MetS phenotype is its converse—that most overweight and obese individuals are metabolically high risk and at substantially elevated risk for diabetes or CVD. Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men.

Biomarkers of endothelial dysfunction and risk of type 2 diabetes mellitus. Risk factors for coronary artery disease in healthy persons with hyperinsulinemia and normal glucose tolerance. Ralph B. We defined diabetes at the baseline exam as a fasting plasma glucose FPG level more than or equal to 7.

  • Recently, neck and wrist circumference were also shown to correlate central obesity but are not commonly used.

  • Our observation that BMI incrementally increased risk among subjects with MetS or IR suggests that additional factors associated with obesity, but not measured in this study, further account for risk of adverse health consequences associated with increased BMI.

  • Those factors increase the risk of developing cardiovascular diseases of atherosclerotic etiology and diabetes mellitus type 2 [ 15 — 9 ], which are the main cause of premature deaths among most of the European and US population [ 10 ]. External link.

  • In addition, the Japan Society for the Study of Obesity has reported that BMI may estimate visceral fat measured using computed tomography as robustly as waist circumference and that obesity-related complications increase with BMI values of 25 [ 118 ].

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Availability of data and materials Please contact author for data requests. WHO Expert Consultation. First, WC measurement requires that patients fast before the examination, to have an empty bladder and to be minimally dressed. MetS b 9.

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Obes Res ; 10 : — Similarly, Bouguerra et al. Sundrome transmission of type 2 diabetes mellitus: the Framingham Offspring Study. Even small reductions in body weight are able to correct abnormalities in the components of MetS, such as hyperglycemia, hyperinsulinemia, and dyslipidemias. Acta Diabetol. The higher under-classification percentage in the overweight category has been documented and can be attributed to the inability of BMI to differentiate between fat mass and lean mass within this intermediate category [ 1119 ]. We also compared the relationship between the prevalence of obesity using BMI, FMI and PBF, and the prevalence of obesity related conditions including dyslipidemia, diabetes, hypertension and metabolic syndrome which represent risk factors predisposing to cardiovascular disease.

Studies in Britain from have indicated that females between the syndrome 12 and 16 had a higher BMI than males of the same age by 1. Insulin resistance syndrom hypersecretion in obesity. Although studies show that metabolic diseases can affect normal-weight adults, studies on the risks of mortality have been equivocal and rarely focus on normal-weight adults. NHANES collects data for people older than 85 but does not report these extreme values to protect privacy. Parental transmission of type 2 diabetes mellitus: the Framingham Offspring Study. For US adults, exponent estimates range from 1.

Ferrera LA, ed. Ruderman and others 4 — 8 identified metabolically obese normal-weight MONW individuals who, despite having a normal-weight BMI, demonstrate metabolic disturbances typical of obese individuals. The clinical role of risk factor clustering as codified in the MetS has thus far been unclear 46but one body mass index metabolic syndrome for MetS may be to discriminate the obese high-risk phenotype from the background population of apparently healthy people at all levels of BMI for purposes of diabetes and CVD prevention. Objective: The objective of this study was to assess risk for diabetes or cardiovascular disease CVD stratified by body mass index BMI and the presence or absence of metabolic syndrome MetS or insulin resistance IR. Therefore, the difference in adiposity of 2 people of similar weight can result in different susceptibility to insulin resistance and MetS, and this difference cannot be determined by BMI values. Journal of the Royal Statistical Society.

This study did not receive any external funding. Neck circumference positively relates to cardiovascular risk factors in college students. Obesity has nearly tripled worldwide since [ 1 ]. Correlation between BMI and waist circumference was analysed according to each component of metabolic syndrome.

  • The prevalence of disease affects the positive and negative predictive values for obesity classification for metabolic syndrome, and therefore may not be applicable to the general population. Height was measured to the nearest 0.

  • We calculated the cumulative incidence of diabetes or CVD as the number of diabetes or CVD events divided by the number of subjects at risk in each category at baseline. TABLE 4.

  • Discordance between fat mass index and body mass index is associated with reduced bone mineral density in women but not in men: the Busselton Healthy Ageing Study.

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  • Funding acquisition by SKK. You have full access to this article via your institution.

There were white women in the cohort; in the 40 to 49 age group, definition the 50 to 59 age group, in the 60 to 69 age group and in the 70 to 79 age group. J Womens Health Larchmt. Ralph B. McLaughlin TAllison GAbbasi FLamendola CReaven G Prevalence of insulin resistance and associated cardiovascular disease risk factors among normal weight, overweight, and obese individuals. Eckel, S.

It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Obesity Silver Spring ; 17 — Clinical data and DXA body composition were obtained. Introduction Obesity is a rapidly growing threat to the health of populations in an increasing number of countries.

Scaling of body composition to height: relevance to height-normalized indexes. Baseline characteristics of body mass index and biochemical variables in Syrian adolescents 18 to 19 years. Correlation between fat mass and blood pressure in healthy children.

Cancel Continue. Our study found that the normal-weight—MetS group had the highest risk of mortality among MetS and obesity categories — a risk that has not been previously identified in US adults. Google Scholar PubMed. Overall, of subjects, 2.

We extend synndrome data to show that, as hypothesized, normal-weight subjects with MetS but not obese subjects without MetS individuals were at substantially elevated risk for both type 2 diabetes or CVD over 7—11 yr of follow-up. Estimation of the concentration of low density lipoprotein cholesterol in plasma, without the use of the preparative ultracentrifuge. Measurement precision of body composition variables using the lunar DPX-L densitometer. We calculated BMI as weight in kilograms divided by the square of height in meters.

Because of differences in questionnaires between NHANES cycles, we included only leisure-time physical activity in our analysis. Overall prevalence. This suggests either that these individual traits were responsible for elevated risk or that their aggregate clustering was the risk factor.

  • J Am Coll Cardiol 40 : —

  • Increased visceral adipose tissue accumulation is more strongly associated with risk of metabolic disorders than subcutaneous adipose tissue because of its location in the abdominal cavity and its large role in endocrine and inflammatory secretion MetS b.

  • Lavrador et al. Offspring subjects are white, of mixed European ancestry.

  • Open in a separate window. Using BMI,

  • The prevalence of metabolic syndrome in our cohort lower than most of the previous studies in the western world. Sign In.

Total no. The metabolic syndrome in older individuals: prevalence and prediction of cardiovascular events: the Cardiovascular Health Study. J Clin Endocrinol Metab 90 index metabolic — Type 2 diabetes or impaired fasting glucose, low high-density lipoprotein and hypertriglyceridemia were all more common among Asians than NHWs. Nutr Metab Cardiovasc Dis. In addition, follow-up longer than 7—11 yr might be required to be certain that obese subjects without risk factors are indeed low risk.

Niger J Health Sci. Natarajan med. Retrieved 7 April Lundgren HBengtsson CBlohme GLapidus LSjostrom L Adiposity and adipose tissue distribution in relation to incidence of diabetes in women: results from a prospective population study in Gothenburg, Sweden. Google Scholar PubMed.

  • We concluded that BMI can serve as a good survey for the primary physician. The role of fat mass index in determining obesity.

  • In other words, BMI is better at determining a person is not obese than it is at determining a person is obese.

  • Medicine Baltimore.

  • Table 2 Classification of blood pressure and metabolic characteristics in Syrian adolescents 18 to 19 years. J Am Coll Cardiol 40 : —

  • Int J Obes Lond.

  • The latter interpretation is supported by our observation that the prevalence of BMI-metabolic risk subphenotypes and the magnitude of their associated risks for diabetes or CVD were very similar when metabolic risk was defined by the presence of IR rather than MetS 6710 ,

National Center for Biotechnology Body mass index metabolic syndromeU. Division by height squared allows normalization for stature [ 627 ]. Detailed demographic characteristics for the cohort were not available to provide further controls for this analysis. See Medicine Baltimore. Given the heterogeneity of the Asian-American population, future studies of Asians in the United States should strive to disaggregate these diverse populations. Obesity is a complex disorder, where genetic predisposition interacts with environmental exposures to produce a heterogeneous phenotype 3. Although our redefinition of metabolic syndrome reduces the comparability of our prevalence rates to other studies, our focus is on the internal comparison between Asian Americans and NHWs, for whom it is similarly defined.

Metbaolic, individuals with high amount of lean mass, that is, large muscle bulk, would be incorrectly classified with obesity. Tamakoshi, and H. Metabolic syndrome across Europe: different clusters of risk factors. To take advantage of all available measures, we needed to account for the correlation of repeated measures from the same patient.

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