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Francisco Álvarez-Nava1,2, Marcia Racines3, Julia Witt1, Jéssica Guarderas1, María Estévez3,4, Roberto Lanes5 1Biological Sciences School, Faculty of Biological Sciences, Central University of Ecuador, Quito, Ecuador; 2Genetic Research Institute, University of Zulia, Maracaibo, Venezuela; 3Institute of Biomedicine Research, Central University of Ecuador; Quito, Ecuador; 4Ecuadorian Foundation in Support of Turner Syndrome, Quito, Ecuador; 5Pediatric Endocrine Unit, Hospital de Clinicas Caracas, Caracas, VenezuelaCorrespondence: Francisco Álvarez-NavaBiological Sciences School, Faculty of Biological Sciences, Central University of Ecuador, Calle Iquique con Calle Sodiro Number N14-121, Parroquia San Blas, Quito, Pichincha 170113, EcuadorTel +593 252 8810Fax +593 252 8810Email fjalvarez@uce.edu.ecBackground and purpose: Excessive adiposity is associated with cardiometabolic complications in Turner syndrome (TS) subjects. Reference data for predictive anthropometric indices of overweight/obesity and metabolic syndrome (MetS) are lacking for subjects with TS. The purpose of this study was to identify the best anthropometric predictor of cardiometabolic risk in a Latin-American cohort of TS subjects.Patients and methods: This was a cross-sectional correlational study conducted in adult TS subjects (n=88) over the past seven years. Anthropometric parameters, body composition and biochemical variables were evaluated in a study and in a reference (n=57) group. Overweight/obesity and MetS were diagnosed using international consensus. The area under the ROC curve (AUC-ROC) was then used to determine the value of each anthropometric variable in predicting MetS or overweight/obesity.Results: The prevalence of MetS and overweight/obesity in TS subjects was 40% and 48%, respectively. All anthropometric and cardiometabolic variables were significantly increased in TS subjects when compared to the reference group, except for body mass index (BMI) and HDL-c. To detect MetS and overweight/obesity, waist to height ratio (WHtR) was found to have a higher correlation with cardiometabolic variables (TC, LDL-c, HDL-c levels and the LDL-c/HDL-c ratio), and to have a higher AUC-ROC and odds ratio than BMI, waist circumference (WC) and the waist to hip ratio (WHR).Conclusion: The prevalence of MetS and overweight/obesity is elevated in TS subjects. WHtR was the most useful variable in predicting the presence of MetS and overweight and obesity in this TS cohort. A combination of WHtR with BMI or with WC could have the best clinical utility in identifying adult TS subjects with overweight/obesity and MetS, respectively.Keywords: anthropometric indexes, body composition, cardiometabolic risk, metabolic syndrome, obesity, overweight, Turner syndrome

The aim of this study was to determine which anthropometric indicators and to what extent are significantly related to the atherogenic index (AI), considering lifestyles (physical inactivity, average calorie consumption/day and smoking), age and sex in an adult population, apparently healthy, attached to a public health hospital in Mexico. Method: Cross-sectional observational study. Sample for convenience: N = 206 (148 women and 58 men). Statistical analysis: Correlational and binary logistic regression using SPSS 19. Results and conclusions: A significant relationship was found between the increase of all anthropometric indicators and the elevation of the AI, regardless of age. The waist/height and waist/hip indicators showed greater weight in this ratio in both sexes. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder caused by anatomic or neuromuscular obstructions. Purpose: To identify the association between anthropometric indexes: neck circumference (NC), abdominal perimeter, and Body Mass Index (BMI), and the presence of OSA in adults. Methods: A retrospective observational case-control study was carried out in 353 individuals between the ages of 18 and 82 years with a polysomnographic diagnosis of OSA. The Apnea-Hypopnea Index was correlated with the anthropometric indexes and demographic data. The control group consisted of 105 adults without OSA and the case group were 248 patients diagnosed with OSA. Pearson Chi-square and Odds Ratio (OR) tests were used for statistical analysis. Results: Statistically significant associations between increased BMI and NC with the presence of OSA in adults were found. The presence of OSA was greater in 56-to-82-year-old women and men. Conclusions: Anthropometric measures BMI and NC are OSA risk factors in adults. [ABSTRACT FROM AUTHOR]

Both waist circumference (WC) and waist-to-hip ratio (WHR) have been proposed as predictors of metabolic syndrome (MetS) in adolescents, but no consensus has been reached to date. This study hypothesizes that WC provides a greater predictive value for MetS in Spanish adolescents than WHR. A cross-sectional study was performed on 1001 adolescents (13.2 ± 1.2 years) randomly recruited from schools in southeast Spain. Anthropometric measures were correlated with the components of MetS (triglycerides, glucose, blood pressure, and high-density lipoprotein cholesterol) as well as inflammation markers (interleukin-6 and tumor necrosis factor–alpha , C-reactive protein, and ceruloplasmin). Receiver-operator curves were created to determine the predictive value of these variables for MetS. Boys had higher values of all anthropometric parameters compared with girls, but the prevalence of MetS was significantly higher in girls. WHR was the only parameter that correlated significantly with all biochemical and inflammatory variables in boys. In girls, WHR, body mass index, waist-to-height ratio, WC, and body fat percentage correlated only with plasma insulin levels, systolic and diastolic pressures, and ceruloplasmin. In both groups, all anthropometric measures were able to predict MetS (area under the curve > 0.94). In particular, WC was able to predict MetS with area under the curve = 1.00. However, WHR was able to predict a higher number of components of MetS. WHR was the anthropometric index that showed the highest predictive value for MetS components, whereas WC was the one that best predicted the MetS among the population of adolescents studied. These findings justify the need to incorporate WHR and WC determinations into daily clinical practice to predict the MetS. [ABSTRACT FROM AUTHOR]

OBJETIVO: Estimar a prevalência de sobrepeso e obesidade entre escolares e sua associação com região, sexo, faixa etária e rede de ensino, e a correlação entre os índices antropométricos. MÉTODO: Estudo transversal com 4.964 escolares entre 6 a 10 anos de idade matriculados em 345 escolas do ensino fundamental do Estado de Santa Catarina. Foi utilizado o índice de massa corporal para diagnosticar sobrepeso e obesidade. Como indicadores de distribuição de gordura foram utilizadas circunferência de cintura, relação cintura-quadril, relação cintura-altura, dobras cutâneas triciptal e subescapular e razão subescapular-triciptal. Foram estimadas as razões de chance com IC 95% e calculada correlação de Pearson para avaliar a relação entre índice de massa corporal e índices antropométricos. RESULTADO: Do total dos escolares, 52,2% eram do sexo feminino. A prevalência de sobrepeso foi de 15,4% e de obesidade 6,0%. Não foi encontrada associação entre sobrepeso ou obesidade com regiões, sexo e faixa etária, somente entre sobrepeso e rede particular. Os escolares da rede particular apresentaram 1,46 (1,22-1,74) vezes mais chance de desenvolverem sobrepeso. Foi encontrada correlação forte entre o índice de massa corporal e a circunferência de cintura (r = 0,90). CONCLUSÃO: Os escolares da rede particular estão mais expostos ao sobrepeso e à obesidade, sugerindo que a condição socioeconômica dos escolares possa ser a explicação. A circunferência de cintura, além de indicador de adiposidade central, poderá ser utilizada como indicador de adiposidade total.OBJECTIVE: To estimate the prevalence of overweight and obesity in school children, their association with region, gender, age, school system, and correlation between anthropometric indexes. METHOD: Cross-sectional study with 4,964 children between 6 and 10 years of age of 345 elementary schools in the state of Santa Catarina. Body mass index was used to diagnose overweight and obesity according to Cole et al. (2000). Waist circumference, waist-to-hip ratio, waist-to-height ratio, triceps and subscapular skinfold thickness, and subscapular-to-triceps ratio were used as fat distribution indexes. We estimated the odds ratio with a 95% CI. To assess the relationship between BMI and anthropometric indexes, Pearson's correlation was calculated. RESULT: 52.2% of the students were female. The prevalence of overweight and obesity were 15.4% and 6.0%. There was no association between overweight or obesity and regions, gender or age; only between overweight and the private network. Children in the private school network were 1.46 (1.22-1.74) times more likely to develop overweight. The correlation between BMI and waist circumference was the strongest (r = 0.90). CONCLUSION: Children in the private school network are more exposed to overweight and obesity than those in the public network, suggesting that socioeconomic conditions of schools could be the explanation. The waist circumference indicator of central adiposity may be used as an indicator of total adiposity.

Objective: To evaluate relationship between varicocele and anthropometric indexes in patients presenting with infertility. Methods: 600 male patients presenting with infertility were included in this study. The presence and degree of varicocele were evaluated by physical examination. Anthropometric index parameters were compared in terms of presence of varicocele and grade. The anthropometric indexes including body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) were recorded. Results: A total of 210 (35%) patients had varicocele. The mean of BMI, WC and WHR of those without varicocele was 30.5 ± 6.4 kg/cm2, 86.40 ± 9.97 cm and 0.89 ± 0.05, respectively. The mean of BMI, WC and WHR with varicocele was 24.7 ± 5.2 kg/cm2, 81.19 ± 9.01 cm and 0.82 ± 0.05 respectively (p<0.001). The mean value of each anthropometric index had a significantly statistical correlation with each grade varicocele (p<0.001). In the normal weight group (BMI less than 25) 82 of 180 patients (45%) had varicoceles. In the overweight group (BMI 25 to less than 30) 94 of 266 patients (34%) had varicoceles. In the obese group (BMI 30 or greater) 34 of 154 patients (21%) had varicoceles (p<0.001). Prevalence of varicocele decreased with increasing body mass index for all varicocele grades (p<0.001). Conclusion: The prevalence of varicocele decreases with increasing body mass index. The present data support the explanation that obesity may result in a decreased nutcracker effect, which accounts for prevention of the renal vein compression. [ABSTRACT FROM AUTHOR]

Purpose: This study proposes to examine the accuracy of four anthropometric indexes of obesity to identify the presence of hypertension and assess differences in the estimation and strength of effect measures of the association between each anthropometric measure and hypertension in Brazilian adults. Methods: A population-based cross-sectional study was carried out with a sample of 1,720 adults from Florianópolis, Brazil. Receiver operating characteristic (ROC) curves were performed to identify the sensitivity and specificity of the best cutoff values for anthropometric indexes (body mass index-BMI, waist circumference-WC, waist-to height ratio-WHtR and conicity index-C-index) for prediction of hypertension. The associations between anthropometric indexes and hypertension were analyzed by Poisson regression expressed as Prevalence Ratios (95% CI) adjusted for socio-demographic variables, health behavior, height, and anthropometric indexes. Results: Of the four anthropometric indexes studied, BMI, WC, and WHtR were found to have the largest areas under the ROC curve relative to hypertension in both sexes. The cutoff values in women and men associated with presence of hypertension were BMI of 24.9 and 24.6 kg/m², WC of 86.2 and 89.5 cm, WHtR of 0.49 and 0.50, and C-index of 1.15 and 1.18, respectively. WC and BMI had greater magnitude of association with presence of hypertension, adjusting for socio-demographic variables, health behavior, height, and anthropometric indexes in women and men, respectively. Conclusions: Anthropometric indexes provide an effective, simple, inexpensive, and non-invasive means for a first-level screening for hypertension. [ABSTRACT FROM AUTHOR]

BackgroundAnthropometric measurements and indexes that assess excess of adiposity are associated with cardiovascular risk factors, and predict diabetes mellitus.MethodsThis cross-sectional study reported the performance of adiposity indexes to detect or turn diabetes unlikely in patients with hypertension. Patients with hypertension (blood pressure (BP) ≥140/90 mm Hg or antihypertensive drug use) aged 18-80 years, being 150 men and 332 women, had weight, height, waist circumference (WC), hip circumference, body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WHtR), and waist-to-square height ratio (WHt2R) calculated. Diabetes was diagnosed by fasting blood glucose ≥126 mg/dl or antidiabetic drug use (23% of the sample).ResultsAll anthropometric indexes were associated with diabetes in a modified Poisson regression, adjusting for age, smoking, and physical activity, in women, but not in men. In men, only the area under the receiver-operating characteristic curve (AUC) for WHR was statistically associated with diabetes (0.67, 95% confidence interval (CI) 0.57-0.77). A cutoff of ≥0.95 had sensitivity of 84.6% (73.3-95.9) and negative post-test probability of 12.8% (3.2-22.4). Among women, WC >88 cm, WHR ≥0.85, and WHtR > 0.54 had sensitivity >93% and negative post-test probability <7.5%.ConclusionsWHR ≥0.85, WC >88.0 cm, and WHtR >0.54 for women and WHR ≥0.95 for men are highly suggestive of diabetes among this population of hypertensive patients. Indexes below these cutoffs turn diabetes unlikely in this context. The investigation of reproducibility of this performance in other outpatient clinics is warranted.American Journal of Hypertension (2011). doi:10.1038/ajh.2010.212 [ABSTRACT FROM AUTHOR]

Background: Anomalies in pulmonary function tests in obese are oriented predominantly to restrictive pathology, not been demonstrated efficiently. Objective: To determine and compare pulmonary function tests (PFT) with anthropometric measurements by spirometry and plethysmograph in asthmatic obese (AO) and non-asthmatic obese (NAO) adolescents. Patients and method: Cross-sectional study, with 86 adolescents. Obesity was defined as body mass index (BMI) greater to 95% percentile according to CDC and asthma, on the basis of the definition and criteria of GINA guidelines. Clinical history was made, doing anthropometric measures and PFT with determination of: forced vital capacity with maximal expiratory effort, forced expiratory volume in the first second, specific resistance and conductance. Results: The average age was 12.68 years ± 1.85, 39 were NAO and 47 AO, who had intermittent to persistent asthma, 14 patients received 200 mcg budesonide/day at least 4 weeks previous to the study. The average values in AO and their standard error for anthropometry were: weight: 68.5 ± 13.6 kg, height: 154.58 ± 9.1 cm, BMI: 28.27 ± 3.24 kg/m2, abdominal circumference (AC): 98 ± 8.85 cm and hip circumference (HC): 100 ± 8.87 cm, in NAO: weight: 76.1 ± 14.7 kg, height: 155.7 ± 7.85 cm, BMI: 31.04 ± 4.46 kg/m2, AC: 102 ± 11.05 cm and HC: 103.28 ± 10.6 cm. Conclusions: In NAO post-β2 Raw diminished whereas Sgaw increased. Greater BMI in AO displayed greater FEV1 with statistic significance. Obstructive ventilator pattern mechanics was observed in both groups. [ABSTRACT FROM AUTHOR]

Obestatin is a recently discovered peptide produced in the stomach, which was originally described to suppress food intake and decrease body weight in experimental animals. We investigated fasting plasma obestatin levels in normal weight, obese and anorectic women and associations of plasma obestatin levels with anthropometric and hormonal parameters. Hormonal (obestatin, ghrelin, leptin, insulin) and anthropometric parameters and body composition were examined in 15 normal weight, 21 obese and 15 anorectic women. Fasting obestatin levels were significantly lower in obese than in normal weight and anorectic women, whereas ghrelin to obestatin ratio was increased in anorectic women. Compared to leptin, only minor differences in plasma obestatin levels were observed in women who greatly differed in the amount of fat stores. However, a negative correlation of fasting obestatin level with body fat indexes might suggest a certain role of obestatin in the regulation of energy homeostasis. A significant relationship between plasma obestatin and ghrelin levels, independent of anthropometric parameters, supports simultaneous secretion of both hormones from the common precursor. Lower plasma obestatin levels in obese women compared to normal weight and anorectic women as well as increased ghrelin to obestatin ratio in anorectic women might play a role in body weight regulation in these pathologies. [ABSTRACT FROM AUTHOR]

Summary: There is growing concern that a single standard definition of overweight and obesity may not suit all ethnic groups. This study aimed to evaluate different anthropometric cut-points as indicators of risk for Type 2 diabetes (T2DM), hypertension and dyslipidaemia in a cross sectional, representative sample of the population of the Kingdom of Tonga (767 subjects: 314 males, 453 females). Anthropometric measurements included weight, height, waist circumference (WAIST), waist-to-hip ratio (WHR), weight-to-height ratio (WhgtR) and percentage body fat (%fat) using bioelectrical impedance. Risk factors investigated were systolic (sBP) and diastolic blood pressure (dBP), plasma glucose, total cholesterol, HDL cholesterol and triglycerides, hypertension and T2DM. The best predictive cut-points were identified using receiver operating characteristic (ROC) curves. The cut-points identified in this cross-sectional study contrast with those from studies in Caucasian and Asian populations. Optimal cut-points for predicting risk for T2DM, dyslipidaemia and hypertension in men were 29.3–31.7kg/m2 for BMI; 98.8–102.9cm for WAIST; 0.91–0.93 for WHR and 0.56–0.60 for WhgtR. For women, the cut-points were 34.0–35.0kg/m2 (BMI), 100.0–102.8cm (WAIST), 0.83–0.86 (WHR) and 0.60–0.62 (WhgtR). Mean area under the curve (AUC) measurements for each index ranged between 0.57 and 0.75 for men and 0.49 and 0.72 for women. The indexes with the highest AUCs for men were WAIST, WhgtR and BMI; and for women were WAIST and WhgtR. Use of a 100cm tape for measuring WAIST is recommended as a simple public health and clinical indicator of risk until longitudinal follow-up studies can confirm findings of this study. [Copyright &y& Elsevier]

We previously reported, using the diagnostic criteria of the International Diabetes Federation (IDF), that waist circumference (WC) and abdominal volume index (AVI) were capable of predicting metabolic syndrome (MetS) in adolescents. This study was aimed at confirming this finding when other diagnostic criteria are used. A cross-sectional study was performed on 981 Spanish adolescents (13.2 ± 1.2 years). MetS was diagnosed by eight different criteria. Ten anthropometric indexes were calculated and receiver-operator curves (ROC) were created to determine their discriminatory capacity for MetS. Of all diagnostic criteria, the ones proposed by the IDF showed the highest mean values for weight, WC and systolic blood pressure in boys and girls with MetS, and the lowest for glucose and triglycerides in boys. ROC analysis showed that only WC, AVI and body roundness index (BRI) achieved area under the curve (AUC) values above 0.8 in boys, and that fat content, body mass index (BMI), WC, AVI, BRI and pediatric body adiposity index (BAIp) showed AUC values above 0.8 in girls. Importantly, this occurred only when diagnosis was carried out using the IDF criteria. We confirm that WC and AVI can predict MetS in adolescents but only when the IDF's diagnostic criteria are employed. [ABSTRACT FROM AUTHOR]

Background: Waist circumference has been suggested as predictor for metabolic syndrome (MetS) in adolescents but it has not been compared with newly proposed anthropometric indexes. This study aimed to disclose the capacity of ten classic and novel anthropometric indexes to discriminate by the presence of MetS in this young population. Materials and methods: A cross‐sectional study was performed on 981 adolescents (13.2 ± 1.2 years) randomly recruited from eighteen schools in south‐east Spain. Body fat percentage (BF%), abdominal volume index (AVI), body roundness index (BRI), body mass index (BMI), body adiposity index (BAI), body adiposity index for paediatrics (BAIp), conicity index (C‐Index), waist circumference (WC), waist‐to‐hip ratio (WHR), waist‐to‐height ratio (WHtR) and body shape index (ABSI) were measured and calculated. Receiver‐operator curves (ROC) were created to determine the discriminatory capacity of these anthropometric parameters for MetS. Results: The prevalence of MetS was 7.0% for boys and 6.1% in girls. Participants with MetS had significantly higher levels of blood pressure and plasma levels of lipids, glucose and insulin. All anthropometric indexes were elevated in MetS individuals compared to the non‐MetS group. AVI and WC showed the highest AUC values (0.83 for boys and 0.86 for girls). In contrast, according to ROC analyses, no anthropometric index was capable of discriminating the components of MetS (hypertension, hypertriglyceridemia, hyperglycaemia and low‐HDL levels), except for abdominal obesity. Conclusion: We suggest the use of WC and AVI, with the cut‐off points presented herein, for the discrimination between adolescents with or without MetS. [ABSTRACT FROM AUTHOR]

One-month treatment of obese patients (body mass index, 39.44 ± 0.94, measured in kg/m²) with a very-low-calorie diet (VLCD) resulted in a significant weight loss, which was higher in men than in women. In contrast, the decrease of percent fat content was higher in gynoid obese women than in men or women with android fat distribution. In females fat mobilization was depressed at the thigh region where a substantially lower percent decrement of thigh skinfold thickness was demonstrated in comparison with males. VLCD treatment positively affected blood pressure and concentrations of total cholesterol, triglyceride, insulin, and cortisol. Total cholesterol-high-density-lipoprotein (HDL) cholesterol ratio remained unchanged and HDL cholesterol in serum significantly declined. Indexes of body fat distribution were not significantly influenced by the short-term treatment by VLCD except waist-hip ratio, which declined in android obese females. VLCD does not decrease a tolerance of physical exercise, as the metabolic response to submaximal workload on a cycle ergometer as well as the responses of cortisol, growth hormone, and prolactin remained unchanged after the treatment. [ABSTRACT FROM AUTHOR]