Influence of a low-carbohydrate diet on endothelial microvesicles in overweight women
Antony WekesaLorna DoyleDoreen FitzmauriceÓrla O’DonovanJohn P. PhelanMark RossKeith S. CrossMichael Harrison
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Low-carbohydrate diets (LCD) are increasing in popularity, but their effect on vascular health has been questioned. Endothelial microvesicles (EMV) are membrane-derived vesicles with the potential to act as a sensitive prognostic biomarker of vascular health and endothelial function. The aim of this study was to examine the influence of a LCD on EMV and other endothelial biomarkers of protein origin. Twenty-four overweight women (age, 48.4 ± 0.6 years; height, 1.60 ± 0.07 m; body mass, 76.5 ± 9.1 kg; body mass index, 28.1 ± 2.7 kg·m(-2); waist circumference, 84.1 ± 7.4 cm; mean ± standard deviation) were randomised to either 24 weeks on their normal diet (ND) or a LCD, after which they crossed over to 24 weeks on the alternative diet. Participants were assisted in reducing carbohydrate intake, but not below 40 g·day(-1). Body composition and endothelial biomarkers were assessed at the crossover point and at the end of the study. Daily carbohydrate intake (87 ± 7 versus 179 ± 11 g) and the percentage of energy derived from carbohydrate (29% versus 44%) were lower (p < 0.05) on the LCD compared to the ND, but absolute fat and saturated fat intake were unchanged. Body mass and waist circumference were 3.7 ± 0.8 kg and 3.5 ± 1.0 cm lower (p < 0.05), respectively, after the LCD compared with the ND phases. CD31(+)CD41(-)EMV, soluble (s) thrombomodulin, sE-selectin, sP-selectin, serum amyloid A and C-reactive protein were lower (p < 0.05) after the LCD compared to the ND, but serum lipids and apolipoproteins were not different. EMV along with a range of endothelial and inflammatory biomarkers are reduced by a LCD that involves modest weight loss.This study aimed to investigate the diagnostic accuracy of body mass index- (BMI-) based and waist circumference- (WC-) based references for childhood overweight and obesity in screening overfat individuals among 2134 Chinese children and adolescents. In this study, overfat status was defined as over 25% body fat for boys and over 30% for girls. Childhood obesity or overweight was defined by four BMI-based references and two WC-based references. All BMI-based references for obesity showed low sensitivity (SE) (0.128–0.473) but high specificity (SP) (0.971–0.998) in detecting overfat individuals in the current population. SE values increased from 0.493 to 0.881 when BMI- and WC-based references for overweight were used to detect overfat individuals. All references for overweight showed high SP rates (0.816–0.966). To improve diagnostic accuracy for childhood obesity, further studies may define a cut-off value for childhood obesity specific for a local population and ethnicity by using health-related overfat data.
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Background Anthropometric measures such as the body mass index (BMI) and waist circumference are widely used as convenient indices of adiposity, yet there are limitations in their estimates of body fat. We aimed to determine the prevalence of obesity using criteria based on the BMI and waist circumference, and to examine the relationship between the BMI and body fat. Methodology/Principal Findings This population-based, cross-sectional study was conducted as part of the Geelong Osteoporosis Study. A random sample of 1,467 men and 1,076 women aged 20–96 years was assessed 2001–2008. Overweight and obesity were identified according to BMI (overweight 25.0–29.9 kg/m2; obesity ≥30.0 kg/m2) and waist circumference (overweight men 94.0–101.9 cm; women 80.0–87.9 cm; obesity men ≥102.0 cm, women ≥88.0 cm); body fat mass was assessed using dual energy X-ray absorptiometry; height and weight were measured and lifestyle factors documented by self-report. According to the BMI, 45.1% (95%CI 42.4–47.9) of men and 30.2% (95%CI 27.4–33.0) of women were overweight and a further 20.2% (95%CI 18.0–22.4) of men and 28.6% (95%CI 25.8–31.3) of women were obese. Using waist circumference, 27.5% (95%CI 25.1–30.0) of men and 23.3% (95%CI 20.8–25.9) of women were overweight, and 29.3% (95%CI 26.9–31.7) of men and 44.1% (95%CI 41.2–47.1) of women, obese. Both criteria indicate that approximately 60% of the population exceeded recommended thresholds for healthy body habitus. There was no consistent pattern apparent between BMI and energy intake. Compared with women, BMI overestimated adiposity in men, whose excess weight was largely attributable to muscular body builds and greater bone mass. BMI also underestimated adiposity in the elderly. Regression models including gender, age and BMI explained 0.825 of the variance in percent body fat. Conclusions/Significance As the BMI does not account for differences in body composition, we suggest that gender- and age-specific thresholds should be considered when the BMI is used to indicate adiposity.
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ObjectiveThe current overweight and central adiposity guidelines based on Western populations were not consistent with many studied based on the Asian populations. Uighur people live in Xinjiang Uighur Autonomous Region which is located in the center of Asia. Their overweight and central cutoffs were largely unknown. We aimed to identify cutoffs for body mass index (BMI; in kg/m2) and waist circumference (WC; in cm) for categorization of overweight and central adiposity among Uighur adults in Xinjiang. Methods4767 Uighur participants were selected from the Cardiovascular Risk Survey (CRS) which was carried out from October 2007 to March 2010. The age of the participants were from 35 to 101 years old with the mean age of 50.09 years. Anthropometric data, blood pressure, serum concentration of serum total cholesterol, triglyceride, low density lipoprotein (LDL), high density lipoprotein (HDL) and fasting glucose were documented. The prevalence, sensitivity, specificity and distance on the receiver operating characteristic (ROC) curve of each BMI and waist circumference values were calculated. ResultsThe prevalence of hypertension, hypercholesterolemia and hypertriglyceridemia were higher with higher BMI for both men and women. The prevalence of hypertension and hypercholesterolemia were higher with higher waist circumference for both men and women. In women, the prevalence of hypertriglyceridemia was noticed to increase as the waist circumference increased. The shortest distance in the receiver operating characteristic curves for hypertension, dyslipidemia, diabetes, or ≥ 2 of these risk factors suggested a BMI cutoff of 26 and a waist circumference cutoff of 90 cm for both men and women. ConclusionsHigher cutoffs for BMI and waist circumference are needed in the identification of Uighur patients at high risk of cardiovascular disease.
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Background: Neck circumference (NC) is a simple screening measure for identifying overweight and obesity. Aims: To determine whether a single measure of NC might be used to identify overweight and obesity, and to define NC cutoff levels for Egyptian overweight and obesity according to existing BMI and WC cutoff levels. Settings and Design: A prospective cross-sectional study from upper and lower Egypt. Materials and Methods: Main indicators included NC, weight, height, waist and hip circumferences (WC) and body mass index (BMI). Results: Pearson's correlation indicated a significant positive association between changes in NC and changes in body mass index and WC in both men and women. ROC analysis showed that the area under the curve (AUC) for NC and BMI >25 kg/m² was 0.80 for men, 0.69 for women, respectively, while that for BMI>30 kg/m² was 0.88 for men, 0.75 for women, respectively. NC ≥ 38 cm for men and ≥ 36 cm for women were the best cut-off points for determining subjects with overweight. Conclusion: NC measurement is simple and timesaving screening measure that can be used to identify overweight and obesity. Patients with NC >38 cm for men and >36 cm for women require additional evaluation of overweight or obesity.
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To compare changes over time in waist circumference (a measure of central fatness) and body mass index (a measure of overall obesity) in British youth.Representative cross sectional surveys in 1977, 1987, and 1997.Great Britain.Young people aged 11-16 years surveyed in 1977 (boys) and 1987 (girls) for the British Standards Institute (n=3784) and in 1997 (both sexes) for the national diet and nutrition survey (n=776).Waist circumference, expressed as a standard deviation score using the first survey as reference, and body mass index (weight(kg)/height(m)2), expressed as a standard deviation score against the British 1990 revised reference. Overweight and obesity were defined as the measurement exceeding the 91st and 98th centile, respectively.Waist circumference increased sharply over the period between surveys (mean increases for boys and girls, 6.9 and 6.2 cm, or 0.84 and 1.02 SD score units, P<0.0001). In centile terms, waist circumference increased more in girls than in boys. Increases in body mass index were smaller and similar by sex (means 1.5 and 1.6, or 0.47 and 0.53 SD score units, P<0.0001). Waist circumference in 1997 exceeded the 91st centile in 28% (n=110) of boys and 38% (n=147) of girls (against 9% for both sexes in 1977-87, P<0.0001), whereas 14% (n=54) and 17% (n=68), respectively, exceeded the 98th centile (3% in 1977-87, P<0.0001). The corresponding rates for body mass index in 1997 were 21% (n=80) of boys and 17% (n=67) of girls exceeding the 91st centile (8% and 6% in 1977-87) and 10% (n=39) and 8% (n=32) exceeding the 98th centile (3% and 2% in 1977-87).Trends in waist circumference during the past 10-20 years have greatly exceeded those in body mass index, particularly in girls, showing that body mass index is a poor proxy for central fatness. Body mass index has therefore systematically underestimated the prevalence of obesity in young people.
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OBJECTIVE To investigate the impact on the prevalence of hypertension by body mass index and waist circumference.METHODS Participants aged 35 and above were investigated by site investigation or household survey.A total of 1426 subjects completed the questionnaire survey and Physical examination.RESULTS The prevalence of hypertension,overall obesity,central obesity and overweight and central obesity in this community were 29.96%,12.52% and 33.26%,respectively.The prevalence of hypertension increased with the BMI,and the risks of hypertension in overweight and obesity,central obesity and overweight and central obesity were higher than population with normal weight and waist circumference.CONCLUSION Overweight and obesity are prevalent in this area.Control of body weight is of great importance to the prevention and treatment of such chronic diseases as hypertension.
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Obesity is associated with a broad spectrum of cardiometabolic diseases that are also present in childhood. Objective. To estimate the prevalence of overweight and obesity in six- to nine- year old children and analyze their relation to high blood pressure (HBP) and central adiposity.Cross-sectional study in 1st to 3rd graders. Weight, height, waist circumference and blood pressure were assessed. We calculated Body Mass Index, and estimated the prevalence of overweight and obesity. Statistical analysis was performed using the Epi Info 6.04 software. Statistical significance: p < 0.05.The general prevalence of overweight and obesity was 17.9% and 16.7%, respectively. Overweight was significantly higher in boys than in girls (p = 0.035); 9.4% of the population had high blood pressure, with no significant gender differences (9.1% and 9.7%). Prevalence of high blood pressure in overweight and obese children was 10.9% and 25%, respectively (p = 0,001). Waist circumference above the 80th percentile was 16.6% in overweight and 26.5% in obese children. The body mass index/waist circumference correlation coefficient was 0.79.This study shows a high prevalence of overweight and a positive association between body mass index or high blood pressure and central adiposity. Preventive measures to control overweight are imperative in the City of Santa Teresita.
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Objective: Ghrelin [acylated (AG) and nonacylated (NAG)] has been shown to play a pivotal role in the regulation of food intake and insulin sensitivity. It is presently unclear whether variation in insulin sensitivity is related to AG and NAG levels in obese individuals. To address this issue, we determined whether insulin-sensitive overweight or obese (ISO) and insulin-resistant overweight or obese (IRO) individuals display different total ghrelin (TotG), AG, and NAG profiles during a euglycemic/hyperinsulinemic clamp (EHC). Design: Eighty-nine nondiabetic overweight and obese postmenopausal women underwent EHC to evaluate insulin sensitivity. Body composition and blood lipid profiles were assessed. Subjects within the highest tertile of insulin sensitivity were described as ISO (n = 31), whereas those within the lowest tertile of insulin sensitivity were considered as IRO (n = 29). Plasma TotG, AG, and NAG profiles were assessed by RIA at 0, 60, 160, 170, and 180 min during the EHC. Results: TotG and NAG levels were significantly decreased for ISO and IRO individuals during the EHC, whereas only ISO subjects displayed a significant reduction of AG concentrations (P < 0.05). AG area under the curve value and the ratio of AG/NAG (fasting and area under the curve) were significantly decreased in ISO individuals. Furthermore, maximal reduction of TotG and AG concentrations was greater in ISO compared with IRO individuals (P < 0.05). Insulin sensitivity was significantly correlated with maximal reduction of TotG (r = 0.36; P < 0.01) and AG (r = 0.36; P < 0.05) concentrations. Conclusion: The dysregulation of ghrelin secretion profiles during EHC is associated with insulin resistance. AG may contribute to the variation of insulin sensitivity in overweight or obese postmenopausal women.
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Background: Cardiovascular disease is associated with lipid abnormalities, hyperglycaemia and overweight. Objectives: To study the relationship between serum lipids and fasting glycaemia with body mass index and waist circumference. Materials and methods: 372 adolescents, 12 to 15 years, participated in a cross sectional study. Associations between Body Mass Index and waist circumference with serum lipids and glycaemia were evaluated. Results: The following prevalence was found: CT≥170 mg/dL, 24.7%; LDLc ≥110 mg/dL, 12.6%; TG≥90 mg/ dL, 34.1%; HDL-c≤45 mg/dL, 6.1% and glycaemia >125mg/dL 10.5%. Overweight prevalence, BMI> p85 was 14.7% and risk of high waist circumference and atypical values was 23.6%. According Chi2, in girls differences were found between glycaemia > 125mg/dl according BMI and WC (p <0.001) and in boys between HDL-c <45mg/dL according WC (p = 0.037) and between TG ≥ 90 mg / dL according BMI (p = 0.040) and WC (p = 0.036). Conclusions: In adolescents studied the prevalence of overweight and central adiposity were high, the relationship between altered TG, HDL-c and hyperglycemia overweight and central adiposity values depend on sex.
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