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Ultra-Processed Food Consumption and Obesity in Korean Adults
Jee-Seon Shim, Kyoung Hwa Ha, Dae Jung Kim, Hyeon Chang Kim
Diabetes Metab J. 2023;47(4):547-558.   Published online April 26, 2023
DOI: https://doi.org/10.4093/dmj.2022.0026
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AbstractAbstract PDFPubReader   ePub   
Background
This study aimed to investigate the association between consumption of ultra-processed foods (UPF) and obesity in Korean adults.
Methods
We included the Cardiovascular and Metabolic Diseases Etiology Research Center cohort study baseline data of adults aged 30 to 64 years who completed a validated food frequency questionnaire. UPF was defined using the NOVA food classification. Multivariable linear and logistic regression analyses were performed to assess the association of dietary energy contribution of UPF with obesity indicators (body mass index [BMI], obesity, waist circumference [WC], and abdominal obesity).
Results
Consumption of UPF accounted for 17.9% of total energy intake and obesity and abdominal obesity prevalence was 35.4% and 30.2%, respectively. Compared with those in the lowest quartile of UPF consumption, adults in the highest quartile had greater BMI (β=0.36; 95% confidence interval [CI], 0.15 to 0.56), WC (β=1.03; 95% CI, 0.46 to 1.60), higher odds of having obesity (odds ratio [OR], 1.24; 95% CI, 1.07 to 1.45), and abdominal obesity (OR, 1.34; 95% CI, 1.14 to 1.57), after adjusting for sociodemographic characteristics, health-related behaviors, and family history of diseases. Dose-response associations between UPF consumption and obesity indicators were consistently found (all P trend <0.01). However, the strength of association was halved for all obesity indicators after further adjustments for total energy intake and overall diet quality score, and the trend toward association for obesity and WC disappeared.
Conclusion
Our finding supports the evidence that consumption of UPF is positively associated with obesity among Korean adults.

Citations

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  • Ultra-processed food consumption and increased risk of metabolic syndrome in Korean adults: A cross-sectional analysis of the KNHANES 2016–2020
    Hansol Park, Youngmi Lee, Jinah Hwang, Yujin Lee
    Nutrition.2024; 122: 112374.     CrossRef
  • Association of maternal ultra-processed food consumption during pregnancy with atopic dermatitis in infancy: Korean Mothers and Children’s Environmental Health (MOCEH) study
    Won Jang, Minji Kim, Eunhee Ha, Hyesook Kim
    Nutrition Journal.2024;[Epub]     CrossRef
  • Diet quality partially mediates the association between ultraprocessed food consumption and adiposity indicators
    Jee‐Seon Shim, Kyoung Hwa Ha, Dae Jung Kim, Hyeon Chang Kim
    Obesity.2023; 31(9): 2430.     CrossRef
  • Development of a Semi-Quantitative Food-Frequency Questionnaire for Korean Adults with Obesity
    Jina Chung, Seoeun Ahn, Hyojee Joung, Sangah Shin
    Nutrients.2023; 15(22): 4848.     CrossRef
Complication
Waist Circumference and Body Mass Index Variability and Incident Diabetic Microvascular Complications: A Post Hoc Analysis of ACCORD Trial
Daniel Nyarko Hukportie, Fu-Rong Li, Rui Zhou, Jia-Zhen Zheng, Xiao-Xiang Wu, Xian-Bo Wu
Diabetes Metab J. 2022;46(5):767-780.   Published online May 10, 2022
DOI: https://doi.org/10.4093/dmj.2021.0258
  • 4,302 View
  • 224 Download
  • 10 Web of Science
  • 11 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Obesity is associated with adverse health events among diabetic patients, however, the relationship between obesity fluctuation and risk of microvascular complications among this specific population is unclear. We aimed to examine the effect of waist circumference (WC) and body mass index (BMI) variability on the risk of diabetic microvascular outcome
Methods
Annually recorded anthropometric data in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was used to examine the association of WC and BMI variability defined as variability independent of mean, with the risk of microvascular outcomes, including neuropathy, nephropathy, and retinopathy. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) (Trial registration: ClinicalTrials.gov., no. NCT00000620).
Results
There were 4,031, 5,369, and 2,601 cases of neuropathy, nephropathy, and retinopathy during a follow-up period of 22,524, 23,941, and 23,850 person-years, respectively. Higher levels of WC and BMI variability were associated with an increased risk of neuropathy. Compared with the lowest quartile, the fully-adjusted HR (95% CI) for the highest quartile of WC and BMI variability for neuropathy risk were 1.21 (1.05 to 1.40) and 1.16 (1.00 to 1.33), respectively. Also, higher quartiles of BMI variability but not WC variability were associated with increased risk of nephropathic events. The fully-adjusted HR (95% CI) for the highest quartile compared with the lowest quartile of BMI variability was 1.31 (1.18 to 1.46). However, the results for retinopathic events were all insignificant.
Conclusion
Among participants with type 2 diabetes mellitus, WC and BMI variability were associated with a higher risk of neuropathic events, whereas BMI variability was associated with an increased risk of nephropathic events.

Citations

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  • Association of body mass index and blood pressure variability with 10-year mortality and renal disease progression in type 2 diabetes
    Stephen Fava, Sascha Reiff
    Acta Diabetologica.2024; 61(6): 747.     CrossRef
  • Investigating the causal association of generalized and abdominal obesity with microvascular complications in patients with type 2 diabetes: A community‐based prospective study
    Jiaheng Chen, Yu Ting Li, Zimin Niu, Zhanpeng He, Yao Jie Xie, Jose Hernandez, Wenyong Huang, Harry H X Wang
    Diabetes, Obesity and Metabolism.2024; 26(7): 2796.     CrossRef
  • Serum Spexin Level Is Negatively Associated With Peripheral Neuropathy and Sensory Pain in Type 2 Diabetes
    Ying Liu, Di Wu, Hangping Zheng, Yunzhi Ni, Lu Zhu, Yaojing Jiang, Jiarong Dai, Quanya Sun, Ying Zhao, Qi Zhang, Yehong Yang, Rui Liu
    Journal of Diabetes Research.2024; 2024: 1.     CrossRef
  • Cardiovascular health metrics and diabetic nephropathy: a nationally representative cross-sectional study
    Yanpei Mai, Si Yan, Liya Gong
    International Urology and Nephrology.2024;[Epub]     CrossRef
  • Waist Circumference and Body Mass Index Variability and Incident Diabetic Microvascular Complications: A Post Hoc Analysis of ACCORD Trial (Diabetes Metab J 2022;46:767-80)
    Yun Kyung Cho
    Diabetes & Metabolism Journal.2023; 47(1): 147.     CrossRef
  • Waist Circumference and Body Mass Index Variability and Incident Diabetic Microvascular Complications: A Post Hoc Analysis of ACCORD Trial (Diabetes Metab J 2022;46:767-80)
    Daniel Nyarko Hukportie, Fu-Rong Li, Rui Zhou, Jia-Zhen Zheng, Xiao-Xiang Wu, Xian-Bo Wu
    Diabetes & Metabolism Journal.2023; 47(1): 150.     CrossRef
  • Weight variability and diabetes complications
    Francesco Prattichizzo, Chiara Frigé, Rosalba La Grotta, Antonio Ceriello
    Diabetes Research and Clinical Practice.2023; 199: 110646.     CrossRef
  • Risk Factors for Diabetic Retinopathy in Latin America (Mexico) and the World: A Systematic Review and Meta-Analysis
    Oscar Vivanco-Rojas, Sonia López-Letayf, Valentina Londoño-Angarita, Fátima Sofía Magaña-Guerrero, Beatriz Buentello-Volante, Yonathan Garfias
    Journal of Clinical Medicine.2023; 12(20): 6583.     CrossRef
  • Effects of body weight variability on risks of macro- and microvascular outcomes in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort
    Claudia R.L. Cardoso, Nathalie C. Leite, Gil F. Salles
    Diabetes Research and Clinical Practice.2023; 205: 110992.     CrossRef
  • Correlation Between the Variability of Different Obesity Indices and Diabetic Kidney Disease: A Retrospective Cohort Study Based on Populations in Taiwan
    Zhenzhen Sun, Kun Wang, Chuan Yun, Fang Bai, Xiaodan Yuan, Yaujiunn Lee, Qingqing Lou
    Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 2791.     CrossRef
  • Unraveling shared risk factors for diabetic foot ulcer: a comprehensive Mendelian randomization analysis
    Kangli Yin, Tianci Qiao, Yongkang Zhang, Jiarui Liu, Yuzhen Wang, Fei Qi, Junlin Deng, Cheng Zhao, Yongcheng Xu, Yemin Cao
    BMJ Open Diabetes Research & Care.2023; 11(6): e003523.     CrossRef
Metabolic Risk/Epidemiology
Impact of Older Age Adiposity on Incident Diabetes: A Community-Based Cohort Study in China
Anthony Chen, Weiju Zhou, Jian Hou, Alan Nevill, Yuanlin Ding, Yuhui Wan, Rebecca Jester, Xia Qin, Zhi Hu, Ruoling Chen
Diabetes Metab J. 2022;46(5):733-746.   Published online April 29, 2022
DOI: https://doi.org/10.4093/dmj.2021.0215
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  • 2 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Obesity classifications vary globally and the impact of older age adiposity on incident diabetes has not been well-studied.
Methods
We examined a random sample of 2,809 participants aged ≥60 years in China, who were free of diabetes at baseline and were followed up for up to 10 years to document diabetes (n=178). The incidence of diabetes was assessed in relation to different cut-off points of body mass index (BMI) and waist circumference (WC) in multiple adjusted Cox regression models.
Results
The diabetic risk in the cohort increased linearly with the continuous and quartile variables of BMI and WC. The BMI-World Health Organization (WHO) and BMI-China criteria analysis did not show such a linear relationship, however, the BMI-Asian/Hong Kong criteria did; adjusted hazards ratio (HR) was 0.42 (95% confidence interval [CI], 0.20 to 0.90) in BMI <20 kg/m2, 1.46 (95% CI, 0.99 to 2.14) in 23–≤26 kg/m2, and 1.63 (95% CI, 1.09 to 2.45) in ≥26 kg/m2. The WC-China criteria revealed a slightly better prediction of diabetes (adjusted HRs were 1.79 [95% CI, 1.21 to 2.66] and 1.87 [95% CI, 1.22 to 2.88] in central obese action levels 1 and 2) than the WC-WHO. The combination of the BMI-Asian/Hong Kong with WC-China demonstrated the strongest prediction. There were no gender differences in the impact of adiposity on diabetes.
Conclusion
In older Chinese, BMI-Asian/Hong Kong criteria is a better predictor of diabetes than other BMI criterion. Its combination with WC-China improved the prediction of adiposity to diabetes, which would help manage bodyweight in older age to reduce the risk of diabetes.

Citations

Citations to this article as recorded by  
  • Investigating Gender and Age Variability in Diabetes Prediction: A Multi-Model Ensemble Learning Approach
    Rishi Jain, Nitin Kumar Tripathi, Millie Pant, Chutiporn Anutariya, Chaklam Silpasuwanchai
    IEEE Access.2024; 12: 71535.     CrossRef
  • Association of air pollution with dementia: a systematic review with meta-analysis including new cohort data from China
    Jie Tang, Anthony Chen, Fan He, Martin Shipley, Alan Nevill, Hugh Coe, Zhi Hu, Tao Zhang, Haidong Kan, Eric Brunner, Xuguang Tao, Ruoling Chen
    Environmental Research.2023; 223: 115048.     CrossRef
  • Impact of fish consumption on all-cause mortality in older people with and without dementia: a community-based cohort study
    Aishat T. Bakre, Anthony Chen, Xuguang Tao, Jian Hou, Yuyou Yao, Alain Nevill, James J. Tang, Sabine Rohrmann, Jindong Ni, Zhi Hu, John Copeland, Ruoling Chen
    European Journal of Nutrition.2022; 61(7): 3785.     CrossRef
Obesity and Metabolic Syndrome
The Association between Z-Score of Log-Transformed A Body Shape Index and Cardiovascular Disease in Korea
Wankyo Chung, Jung Hwan Park, Hye Soo Chung, Jae Myung Yu, Shinje Moon, Dong Sun Kim
Diabetes Metab J. 2019;43(5):675-682.   Published online April 26, 2019
DOI: https://doi.org/10.4093/dmj.2018.0169
  • 8,075 View
  • 59 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

In order to overcome the limitations of body mass index (BMI) and waist circumference (WC), the z-score of the log-transformed A Body Shape Index (LBSIZ) has recently been introduced. In this study, we analyzed the relationship between the LBSIZ and cardiovascular disease (CVD) in a Korean representative sample.

Methods

Data were collected from the Korea National Health and Nutrition Examination VI to V. The association between CVD and obesity indices was analyzed using a receiver operating characteristic curve. The cut-off value for the LBSIZ was estimated using the Youden index, and the odds ratio (OR) for CVD was determined via multivariate logistic regression analysis. ORs according to the LBSIZ value were analyzed using restricted cubic spline regression plots.

Results

A total of 31,227 Korean healthy adults were analyzed. Area under the curve (AUC) of LBSIZ against CVD was 0.686 (95% confidence interval [CI], 0.671 to 0.702), which was significantly higher than the AUC of BMI (0.583; 95% CI, 0.567 to 0.599) or WC (0.646; 95% CI, 0.631 to 0.661) (P<0.001). Similar results were observed for stroke and coronary artery diseases. The cut-off value for the LBSIZ was 0.35 (sensitivity, 64.5%; specificity, 64%; OR, 1.29, 95% CI, 1.12 to 1.49). Under restricted cubic spline regression, LBSIZ demonstrated that OR started to increase past the median value.

Conclusion

The findings of this study suggest that the LBSIZ might be more strongly associated with CVD risks compared to BMI or WC. These outcomes would be helpful for CVD risk assessment in clinical settings, especially the cut-off value of the LBSIZ suggested in this study.

Citations

Citations to this article as recorded by  
  • Body Shape Index and Cardiovascular Risk in Individuals With Obesity
    Nazlı Hacıağaoğlu, Can Öner, Hüseyin Çetin, Engin Ersin Şimşek
    Cureus.2022;[Epub]     CrossRef
  • Association between body shape index and risk of mortality in the United States
    Heysoo Lee, Hye Soo Chung, Yoon Jung Kim, Min Kyu Choi, Yong Kyun Roh, Wankyo Chung, Jae Myung Yu, Chang-Myung Oh, Shinje Moon
    Scientific Reports.2022;[Epub]     CrossRef
  • Utility of the Z-score of log-transformed A Body Shape Index (LBSIZ) in the assessment for sarcopenic obesity and cardiovascular disease risk in the United States
    Wankyo Chung, Jung Hwan Park, Hye Soo Chung, Jae Myung Yu, Dong Sun Kim, Shinje Moon
    Scientific Reports.2019;[Epub]     CrossRef
Obesity and Metabolic Syndrome
The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study
Jung-Hwan Cho, Eun-Jung Rhee, Se-Eun Park, Hyemi Kwon, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Hye Soon Park, Yang-Hyun Kim, Soon-Jib Yoo, Won-Young Lee
Diabetes Metab J. 2019;43(2):206-221.   Published online December 27, 2018
DOI: https://doi.org/10.4093/dmj.2018.0039
  • 6,164 View
  • 107 Download
  • 24 Web of Science
  • 24 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Waist circumference (WC) is a well-known obesity index that predicts cardiovascular disease (CVD). We studied the relationship between baseline WC and development of incident myocardial infarction (MI) and ischemic stroke (IS) using a nationwide population-based cohort, and evaluated if its predictability is better than body mass index (BMI).

Methods

Our study included 21,749,261 Koreans over 20 years of age who underwent the Korean National Health Screening between 2009 and 2012. The occurrence of MI or IS was investigated until the end of 2015 using National Health Insurance Service data.

Results

A total of 127,289 and 181,637 subjects were newly diagnosed with MI and IS. The incidence rate and hazard ratio of MI and IS increased linearly as the WC level increased, regardless of adjustment for BMI. When the analyses were performed according to 11 groups of WC, the lowest risk of MI was found in subjects with WC of 70 to 74.9 and 65 to 69.9 cm in male and female, and the lowest risk of IS in subjects with WC of 65 to 69.9 and 60 to 64.9 cm in male and female, respectively. WC showed a better ability to predict CVD than BMI with smaller Akaike information criterion. The optimal WC cutoffs were 84/78 cm for male/female for predicting MI, and 85/78 cm for male/female for predicting IS.

Conclusion

WC had a significant linear relationship with the risk of MI and IS and the risk began to increase from a WC that was lower than expected.

Citations

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  • Usefulness of New Criteria for Metabolic Syndrome Optimized for Prediction of Cardiovascular Diseases in Japanese
    Yurie Yamazaki, Kazuya Fujihara, Takaaki Sato, Mayuko Harada Yamada, Yuta Yaguchi, Yasuhiro Matsubayashi, Takaho Yamada, Satoru Kodama, Kiminori Kato, Hitoshi Shimano, Hirohito Sone
    Journal of Atherosclerosis and Thrombosis.2024; 31(4): 382.     CrossRef
  • Association between body composition and subsequent cardiovascular diseases among 5-year breast cancer survivors
    Ji Soo Kim, Jihun Song, Seulggie Choi, Sung Min Kim, Young Jun Park, Sun Jae Park, Yoosun Cho, Yun Hwan Oh, Seogsong Jeong, Kyae Hyung Kim, Sang Min Park
    Nutrition, Metabolism and Cardiovascular Diseases.2024;[Epub]     CrossRef
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    Dae Young Cheon, Kyung do Han, Yeon Jung Lee, Jeen Hwa Lee, Myung Soo Park, Do Young Kim, Jae Hyuk Choi, Sook Jin Lee, Kyung-Ho Yu, Seongwoo Han, Sunki Lee, Minwoo Lee
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    Jung Eun Yoo, Kyungdo Han, Jin‐Hyung Jung, Yang‐Im Hur, Yang Hyun Kim, Eun Sook Kim, Jang Won Son, Eun‐Jung Rhee, Won‐Young Lee, Ga Eun Nam
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    Mi Hong Yim, Young Ju Jeon, Bum Ju Lee
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    Eun-Jung Rhee
    Cardiovascular Prevention and Pharmacotherapy.2023; 5(2): 35.     CrossRef
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    Jiayi Ye, Yanjie Hu, Xinrong Chen, Zhe Yin, Xingzhu Yuan, Liping Huang, Ka Li
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    Ji Soo Kim, Jihun Song, Seulggie Choi, Sang Min Park
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    Jong Yeon Kim, Sung Min Cho, Youngmin Yoo, Taesic Lee, Jong Koo Kim
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    Nathalia Garrido-Torres, Miguel Ruiz-Veguilla, Luis Alameda, Manuel Canal-Rivero, María Juncal Ruiz, Marcos Gómez-Revuelta, Rosa Ayesa-Arriola, Ana Rubio-García, Benedicto Crespo-Facorro, Javier Vázquez-Bourgon
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    X. Shao, H. Liu, F. Hou, Y. Bai, Z. Cui, Y. Lin, X. Jiang, P. Bai, Y. Wang, Y. Zhang, C. Lu, H. Liu, S. Zhou, P. Yu
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    Tingting Hu, Yun Shen, Weijie Cao, Yiting Xu, Yufei Wang, Xiaojing Ma, Yuqian Bao
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    Liang Wang, Yujin Lee, Yuntao Wu, Xinyuan Zhang, Cheng Jin, Zhe Huang, Yixin Wang, Zhiyi Wang, Penny Kris-Etherton, Shouling Wu, Xiang Gao
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    Chang-Hoon Lee, Kyung-Do Han, Da Hye Kim, Min-Sun Kwak
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    Hye Soon Kim
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    Ga Eun Nam, Yang-Hyun Kim, Kyungdo Han, Jin-Hyung Jung, Yong Gyu Park, Kwan-Woo Lee, Eun-Jung Rhee, Jang Won Son, Seong-Su Lee, Hyuk-Sang Kwon, Won-Young Lee, Soon Jib Yoo
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    Jie-Eun Lee
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  • Association and Interaction Analysis of Lipid Accumulation Product with Impaired Fasting Glucose Risk: A Cross-Sectional Survey
    Jian Song, Xue Chen, Yuhong Jiang, Jing Mi, Yuyuan Zhang, Yingying Zhao, Xuesen Wu, Huaiquan Gao
    Journal of Diabetes Research.2019; 2019: 1.     CrossRef
  • Letter: Association of Z-Score of the Log-Transformed A Body Shape Index with Cardiovascular Disease in People Who Are Obese but Metabolically Healthy: The Korea National Health and Nutrition Examination Survey 2007-2010 (J Obes Metab Syndr 2018;27:158-65
    Eun-Jung Rhee
    Journal of Obesity & Metabolic Syndrome.2019; 28(2): 139.     CrossRef
  • Response: The Differential Association between Muscle Strength and Diabetes Mellitus According to the Presence or Absence of Obesity (J Obes Metab Syndr 2019;28:46-52)
    Bo Kyung Koo
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Obesity and Metabolic Syndrome
Association between Blood Mercury Level and Visceral Adiposity in Adults
Jong Suk Park, Kyoung Hwa Ha, Ka He, Dae Jung Kim
Diabetes Metab J. 2017;41(2):113-120.   Published online December 21, 2016
DOI: https://doi.org/10.4093/dmj.2017.41.2.113
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  • 38 Web of Science
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AbstractAbstract PDFPubReader   
Background

Few studies have examined the association between mercury exposure and obesity. The aim of this study is to investigate the association between blood mercury concentrations and indices of obesity in adults.

Methods

A total of 200 healthy subjects, aged 30 to 64 years, who had no history of cardiovascular or malignant disease, were examined. Anthropometric and various biochemical profiles were measured. Visceral adipose tissue (VAT) was measured using dual-energy X-ray absorptiometry (DXA).

Results

All subjects were divided into three groups according to blood mercury concentrations. Compared with the subjects in the lowest tertile of mercury, those in the highest tertile were more likely to be male; were current alcohol drinkers and smokers; had a higher body mass index (BMI), waist circumference (WC), and VAT; had higher levels of blood pressure, fasting glucose, and insulin resistance; and consumed more fish. The blood mercury concentration was significantly associated with anthropometric parameters, showing relationships with BMI, WC, and VAT. After adjusting for multiple risk factors, the odds ratios (ORs) for high mercury concentration was significantly higher in the highest VAT tertile than in the lowest VAT tertile (OR, 2.66; 95% confidence interval, 1.05 to 6.62; P<0.05).

Conclusion

The blood mercury concentration was significantly associated with VAT in healthy adults. Further studies are warranted to confirm our findings.

Citations

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  • Exposure to Metal Mixtures and Overweight or Obesity Among Chinese Adults
    Gaojie Fan, Qing Liu, Mingyang Wu, Jianing Bi, Xiya Qin, Qing Fang, Zhengce Wan, Yongman Lv, Youjie Wang, Lulu Song
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    Giancarlo Garofalo, Tyson Nielsen, Samuel Caito
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    Min Kyong Moon, Inae Lee, Aram Lee, Hyunwoong Park, Min Joo Kim, Sunmi Kim, Yoon Hee Cho, Sooyeon Hong, Jiyoung Yoo, Gi Jeong Cheon, Kyungho Choi, Young Joo Park, Jeongim Park
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    Héctor Hernández-Mendoza, Héctor Edmundo Álvarez-Loredo, Elizabeth Teresita Romero-Guzmán, Darío Gaytán-Hernández, Consuelo Chang-Rueda, Israel Martínez-Navarro, Bertha Irene Juárez-Flores, María Judith Rios-Lugo
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Optimal Waist Circumference Cutoff Value Based on Insulin Resistance and Visceral Obesity in Koreans with Type 2 Diabetes
Jung Soo Lim, Young Ju Choi, Soo-Kyung Kim, Byoung Wook Huh, Eun Jig Lee, Kap Bum Huh
Diabetes Metab J. 2015;39(3):253-263.   Published online April 24, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.3.253
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Visceral obesity is the most powerful contributor to the development of metabolic syndrome (MetS) and cardiovascular diseases. In light of visceral obesity, however, there is a paucity of data on the appropriate cutoff point of waist circumference (WC) in subjects with type 2 diabetes. The aim of this study was to investigate the optimal cutoff value for WC that signals insulin resistance (IR) and visceral obesity in Koreans with type 2 diabetes.

Methods

We evaluated 4,252 patients with type 2 diabetes (male 2,220, female 2,032, mean age 57.24 years) who visited our clinic between January 2003 and June 2009. WC was measured at the midpoint between the lower rib and the iliac crest, and insulin sensitivity was assessed by the rate constant of plasma glucose disappearance (Kitt %/min) using an insulin tolerance test. Visceral fat thickness was measured using ultrasonography. Statistical analysis was performed using receiver operating characteristic curve.

Results

The optimal cutoff points for WC for identifying the presence of IR and visceral obesity, as well as two or more metabolic components, were 87 cm for men and 81 cm for women. Moreover, these cutoff points had the highest predictive powers for the presence of visceral obesity. The MetS defined by new criteria correlated with the increased carotid intima-media thickness in female subjects.

Conclusion

Our results suggest that the optimal cutoff values for WC in Koreans with type 2 diabetes should be reestablished based on IR and visceral obesity.

Citations

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Cardio-Metabolic Features of Type 2 Diabetes Subjects Discordant in the Diagnosis of Metabolic Syndrome
Sa Rah Lee, Ying Han, Ja Won Kim, Ja Young Park, Ji Min Kim, Sunghwan Suh, Mi-Kyoung Park, Hye-Jeong Lee, Duk Kyu Kim
Diabetes Metab J. 2012;36(5):357-363.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.357
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AbstractAbstract PDFPubReader   
Background

The aim of this study is to investigate the cardio-metabolic parameters and surrogate markers of insulin resistance in a discordant group of type 2 diabetes (T2DM) subjects who satisfy the Adults Treatment Panel (ATP) III criteria, but not the International Diabetes Federation (IDF) criteria, for metabolic syndrome (MetS).

Methods

We assessed the prevalence of MetS in T2DM subjects (n=167) who were selected from subjects registered at the diabetes center of Dong-A University Medical Center. We used the ATP III criteria and the IDF criteria for the diagnosis of MetS and sorted the subjects into 2 MetS groups: one group diagnosed per ATP III criteria (MetSa) and one diagnosed per IDF criteria (MetSi). We then compared the clinical characteristics, metabolic parameters (homeostasis model assessment of insulin resistance, aspartate aminotransferase, alanine aminotransferase, and uric acid values) and co-morbidities (prevalence of microalbuminuria, fatty liver, and cardiovascular disease) between the MetSa, MetSi, and discordant MetS groups.

Results

The prevalence of MetS in the MetSa group (73.6%) was higher than in the MetSi group (62.2%). The MetS prevalence in the discordant group was 11.4%. The discordant group showed no significant differences in clinical characteristics (except waist circumference and body mass index), metabolic parameters, or prevalence of co-morbidities, as compared with subjects with MetS by both criteria.

Conclusion

In this study, cardio-metabolic features of the subjects diagnosed with MetS using ATP III criteria, but not IDF criteria, are not significantly different from those of subjects diagnosed with MetS using both criteria.

Citations

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    Ping Liu, Shujian Sui, Dongling Xu, Xiaowei Xing, Caixia Liu
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    Ping Liu, Shujian Sui, Dongling Xu, Xiaowei Xing, Caixia Liu
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The Correlations between Extremity Circumferences with Total and Regional Amounts of Skeletal Muscle and Muscle Strength in Obese Women with Type 2 Diabetes
Hwi Ryun Kwon, Kyung Ah Han, Hee Jung Ahn, Jae Hyuk Lee, Gang Seo Park, Kyung Wan Min
Diabetes Metab J. 2011;35(4):374-383.   Published online August 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.4.374
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  • 14 Crossref
AbstractAbstract PDFPubReader   
Background

Insulin resistance is related to central obesity and the amount of skeletal muscle. A simple and practical anthropometric marker for muscle mass is not known, although waist circumference (WC) is used as an indicator of abdominal obesity. The aims of this study were to investigate whether arm (AC) and thigh circumferences (TC) can be used as an indicator of muscle mass and if they are related to muscle strength.

Methods

A total of 110 obese (body mass index [BMI]≥25 kg/m2) women with type 2 diabetes were enrolled, and WC, AC, and TC were measured. Abdominal visceral fat (AVF), subcutaneous fat (ASF), and total fat (ATF) were assessed by computed tomography, regional muscle (MM), and fat mass by dual-energy X-ray absorptiometry, muscle strength by one repetition maximum (1RM) of both extremities (chest and leg press) and insulin resistance by KITT.

Results

The mean age was 56.2±7.3 years, duration of diabetes was 4.2±4.4 years, and BMI was 27.2±2.8 kg/m2. WC was correlated with ATF, AVF, and ASF (r=0.728, P<0.001; r=0.515, P<0.001; r=0.608, P<0.001, respectively). Arm MM was correlated with AC (r=0.500, P<0.001), and leg MM with TC (r=0.291, P=0.002). Upper 1RM was related to AC/WC ratio (r=0.359, P<0.001), and lower 1RM was to TC/WC ratio (r=0.286, P=0.003). Insulin resistance had significant relations with AVF, WC, and total MM (r=-0.262, P=0.008; r=-0.217, P=0.029; r=0.160, P=0.031, respectively).

Conclusion

The muscle mass was related to extremity circumferences, and muscle strength was to extremity/waist circumference ratio in obese women with type 2 diabetes.

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Waist Circumference May be More Important than Body Mass Index (BMI) in Determinants of Left Ventricular Mass in Korean Hypertensive Patients.
Yoon Hyeuk Lim, Byoung Hyun Park, Sung Zoo Kim, Chung Gu Cho
Korean Diabetes J. 2007;31(2):130-135.   Published online March 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.2.130
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AbstractAbstract PDF
BACKGROUND
In many studies, obesity is highly correlated with adverse coronary risk profile. Increased left ventricular (LV) mass is an independent risk factor for cardiovascular mortality and morbidity. Hypertension is an well known factor related with LV mass. Obesity also is related with LV mass and commonly associated with hypertension. However, few data are available concerning the relations of LV mass to central obesity, especially in Korean hypertensive patients. So, this study was to evaluate the significance of waist circumference in determinants of LV mass in Korean hypertensive patients. METHODS: A total of 74 hypertensive [40 women, 34 men; mean age, 62.5 years; mean body mass index (BMI), 25.0 kg/m2, 17 with type 2 diabetes] patients without prevalent cardiovascular disease were studied. Echocardiographic LV septal thickness, LV posterior wall thickness, LV dimension and LV mass were analysed. RESULTS: LV mass, diastolic left ventricular internal dimension and epicardial fat thickness were larger in men than in female. LV mass was larger in obese patients defined by body mass index and also in central obese patients defined by waist circumference. LV mass was correlated with sex, body mass index, waist circumference, diastolic left ventricular internal dimension, left ventricular posterior wall thickness and interventricular septal thickness. After controlling for age, sex and body mass index, waist circumference was correlated with LV posterior wall thickness and LV mass. CONCLUSION: Waist circumference may be more important than BMI in determinants of left ventricular mass in Korean hypertensive patients.
Waist Circumference as a Risk Factor for Metabolic Syndrome in Korean Adult ; Evaluation from 5 Different Criteria of Metabolic Syndrome.
H J Lee, H S Kwon, Y M Park, H N Chun, Y H Choi, S H Ko, J M Lee, K H Yoon, B Y Cha, W C Lee, K W Lee, H Y Son, S K Kang, M S Ahn, J M Kang, D S Kim
Korean Diabetes J. 2005;29(1):48-56.   Published online January 1, 2005
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AbstractAbstract PDF
BACKGROUND
Many different criteria for defining metabolic syndrome have been suggested. The prevalence of metabolic syndrome differs according to each set of criteria. This study was performed to estimate the prevalence of metabolic syndrome in middle-aged Korean people using five different criteria. METHODS: This was a population based, cross-sectional study including 5,330 participants (2,197 males and 3,133 females), over the age 40, conducted in a rural area of Korea. The prevalence of metabolic syndrome was assessed according to the NCEP-ATP III criterion, Asian Pacific region criterion for abdominal obesity (modified ATP III), WHO criterion, American Association of Clinical Endocrinologists (AACE) and European Group for the Study of Insulin (EGIR) criterion. We performed anthropometry and laboratory test on the 5,330 subjects, and the prevalence of metabolic syndrome was determined according to the five different definition. RESULTS: The prevalence of metabolic syndrome using the modified ATP III, NCEP- ATP III, WHO, AACE and EGIR criteria were 33.8 (27.0% in men and 38.7% in women), 23.8 (17.5% in men and 28.3% in women), 23.7 (26.5% in men and 21.7% in women.), 30.1 (22.4% in men and 35.4% in women) and 15.2% (12.9% in men and 16.9% in women), respectively. CONCLUSION: The prevalence of metabolic syndrome was quite different in the same population according to the different definitions applied. Further studies, including a prospective study on metabolic syndrome, will be needed to clarify the definition and clinical characteristics of metabolic syndrome in Korea

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