Metabolic syndrome abdominal obesity measurement -
Specifically it is the deepest layer of belly fat the fat that cannot be seen or grabbed that poses health risks, as these "visceral" fat cells produce hormones that can affect health e. The risk increases considering the fact that they are located in the proximity or in between organs in the abdominal cavity.
For example, fat next to the liver drains into it, causing a fatty liver , which is a risk factor for insulin resistance, setting the stage for type 2 diabetes. However, visceral fat is more responsive to the circulation of catecholamines.
In the presence of type 2 diabetes , the physician might instead prescribe metformin and thiazolidinediones rosiglitazone or pioglitazone as antidiabetic drugs rather than sulfonylurea derivatives. Thiazolidinediones may cause slight weight gain but decrease "pathologic" abdominal fat visceral fat , and therefore may be prescribed for diabetics with central obesity.
Low-fat diets may not be an effective long-term intervention for obesity: as Bacon and Aphramor wrote, "The majority of individuals regain virtually all of the weight that was lost during treatment. The conclusion was that mean weight decreased significantly in the intervention group from baseline to year 1 by 2.
This difference from baseline between control and intervention groups diminished over time, but a significant difference in weight was maintained through year 9, the end of the study. There is a common misconception that spot exercise that is, exercising a specific muscle or location of the body most effectively burns fat at the desired location, but this is not the case.
Spot exercise is beneficial for building specific muscles, but it has little effect, if any, on fat in that area of the body, or on the body's distribution of body fat. The same logic applies to sit-ups and belly fat.
Sit-ups , crunches and other abdominal exercises are useful in building the abdominal muscles , but they have little effect, if any, on the adipose tissue located there. A large central adiposity deposit has been assigned many common use names, including "spare tire", "love handle", "paunch", and "potbelly".
However, there is little scientific evidence that beer drinkers are more prone to central obesity, despite its being known colloquially as "beer belly", "beer gut", or "beer pot".
One of the few studies conducted on the subject did not find that beer drinkers are more prone to central obesity than nondrinkers or drinkers of wine or spirits. These symptoms can suggest the appearance of central obesity.
Deposits of excess fat at the sides of one's waistline or obliques are commonly referred to as "love handles". Researchers in Copenhagen examined the relationship between waist circumferences and costs among 31, subjects aged 50—64 years of age with different waist circumferences.
Their study showed that an increase in just an additional centimetre above normal waistline caused a 1. To put this in perspective, a woman with a waistline of 95 cm approx Contents move to sidebar hide. Article Talk. Read Edit View history. Tools Tools. What links here Related changes Upload file Special pages Permanent link Page information Cite this page Get shortened URL Download QR code Wikidata item.
Download as PDF Printable version. In other projects. Wikimedia Commons. Excess fat around the stomach and abdomen. Medical condition. See also: Diet and obesity. This section needs expansion. You can help by adding to it. January doi : PMID S2CID Dementia and Geriatric Cognitive Disorders.
Diabetes Care. Coronary Heart Disease. Journal of Diabetes and Its Complications. S2CID — via PubMed. Clinical Cornerstone. Bibcode : Natur. Retrieved European Journal of Epidemiology. PMC Somers, V. Lopez-Jimenez, F. Korenfeld, Y. Palin, S. Boelaert, K. Boarin, S. Sierra-Johnson, J.
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Hence, measuring waist circumference could be recommended as a simple and efficient tool for screening abdominal obesity and related metabolic risk even in non-obese individuals. Peer Review reports. Obesity is one of the major public health concerns of our era: its prevalence has increased significantly in the past decades both globally [ 1 , 2 ] and in Hungary [ 3 , 4 ].
In Hungary, many people live with a high risk of metabolic syndrome, which promotes the development of atherosclerotic vascular diseases and type 2 diabetes mellitus T2DM [ 5 ], mainly due to abdominal obesity.
Therefore, it is essential for heath professionals to be aware of the metabolic risk of this population. Body mass index BMI is widely used to monitor the prevalence of obesity because the risk of coronary heart disease, ischemic stroke, and T2DM rises in parallel with the increase in the BMI [ 8 ].
Unfortunately, BMI provides limited information about body fat content and no information on central fat distribution, the degree of which may be more closely related to metabolic risks than BMI itself [ 9 ].
Body adiposity varies according to age and gender, and BMI alone is not appropriate to distinguish between persons with excess body fat and persons with high muscle mass, to whom the same metabolic risk would be attributed based purely on their BMI [ 10 ].
Nonetheless, several reports suggest that the measurement of waist circumference WC can compensate the above described limitation of BMI since WC is more closely related to visceral fat content, and thus to metabolic risks.
Previous research shows that on the one hand, normal weight individuals with abdominal obesity can have metabolic risk factors, and therefore being candidates for having elevated risk for metabolic syndrome [ 11 ] or cardiovascular diseases CVDs [ 12 ], and on the other hand, measurements of abdominal obesity, principally WC, are more closely related to metabolic risk factors than the index of general adiposity [ 13 ].
According to Park et al. Subjects with abdominal obesity were more likely to have a metabolic syndrome compared to those without abdominal obesity, therefore, WC should also be measured and used in conjunction with BMI to assess and predict metabolic risk, where possible, according to the conclusion of a recent report of the World Health Organization WHO [ 8 ].
There is, however, limited information about the usefulness of WC measurement in identifying cardiometabolic risk factors in a large study sample. Therefore, in our study, we aimed to examine whether non-obese subjects with no chronic conditions but abdominal obesity had a higher chance of having related metabolic risk factors, such as elevated blood pressure, high fasting blood glucose, high cholesterol, high low-density lipoprotein LDL , low high-density lipoprotein HDL , and high triglyceride levels, compared to persons with no abdominal obesity.
The aim of the Programme was to provide efficient preventive services, contributing thereby to the improvement of the general health status of the population, and the reduction of social health inequality [ 14 ].
The health check surveyed the sociodemographic status, lifestyle and health attitude nutrition, physical activity, alcohol use, smoking , mental health, and history of chronic diseases and screenings for cardiometabolic risk factors and hidden diseases.
The Health Status Assessment HSA was implemented by a team of a trained nurse and a trained public health practitioner [ 17 ], the task of who was to recruit the subjects, collect questionnaire-based data, and perform the physical and laboratory examinations.
It was a cross-sectional study conducted in adult persons taking part in the Programme, living in the two vulnerable regions of Hungary located in the North Eastern part of the country.
The target population comprised 32 adults, and the health data of 20 successfully recruited adult persons were recorded between July and February The final sample was formed by non-obese individuals, who were divided into two groups according to the WC.
There were persons in the group of normal WC NWC , and persons in the group of high WC HWC Fig 1. The HSA involved a health interview, physical examination performed by a public health practitioner and a community nurse , and laboratory tests.
The data collected and the questions applied in the HSA are shown in Additional file 2 see Additional file 2. Based on the definition of metabolic syndrome [ 18 ], laboratory data of blood glucose, total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels were used.
The thresholds for laboratory parameters given by the ATP III or the WHO [ 19 ] are shown in Table 1. The public health professionals followed the WHO STEPS STEPwise approach to surveillance protocol to measure the WC, that is, the measurement is made at the approximate midpoint between the lowest rib and the iliac crest [ 20 ].
Blood pressure was measured by electronic blood pressure monitor after a five-minute rest. A chi-square test was performed to show the basic characteristics of the two groups. A multiple logistic regression model was used to define the association between the metabolic risk factors and abdominal obesity with adjustments for age and gender.
Metabolic risk factors were used as dependent variables, and abdominal obesity was defined as an independent variable. A p-value lower than 0. Statistical analysis was performed by using the SPSS The final sample involved non-obese subjects. Out of them, subjects Both groups involved more women than men, and the majority of the patients were young 18—29 years or middle-aged 30—44 years Table 2.
The levels of HDL and LDL cholesterol were not significantly different between the two groups. According to the results of the multiple logistic regression models, older people had significantly higher odds for developing most of the metabolic risk factors. Subjects in the age group of 30—44 years were significantly more likely to have high systolic blood pressure, high fasting blood glucose, high total cholesterol, and high LDL cholesterol levels compared to the 18—29 year age group Table 3.
This significantly increased risk of the occurrence of the above mentioned metabolic risk factors was shown in the older age groups. An increased risk for high triglyceride level was observed in the 45—59 and 60—74 year old age groups compared to the youngest age group.
Subjects in the 45—59 and 60—74 year old age groups had significantly lower odds for low HDL cholesterol. In contrast, the risk increased in the oldest age group, although not significantly Table 3.
Regarding gender, males had significantly higher odds for having high systolic blood pressure, high fasting blood glucose, low HDL cholesterol, and high triglyceride levels Table 3.
Subjects in the HWC group were more likely to have some metabolic risk factors compared to those in the NWC group. If a patient had abdominal obesity, the odds for high systolic blood pressure, low HDL cholesterol, and high triglyceride levels increased significantly Table 3.
On the contrary, the risk for high LDL level was lower in the HWC group compared to the NWC group, but it was not significant. The odds of high total cholesterol level was nearly the same in the NWC and the HWC groups Table 3.
In this cross-sectional study, we examined the association of abdominal obesity assessed by WC with the occurrence of metabolic risk factors in non-obese subjects. Our results showed a high prevalence of abdominal obesity Our study also presented a very high, positive correlation between BMI and WC, which is consistent with other studies [ 23 , 24 ].
Subjects with abdominal obesity were proved to have significantly higher prevalence of high systolic blood pressure, high fasting blood glucose, high total cholesterol, and high triglyceride levels than subjects in the NWC group. The risk for having high systolic blood pressure, high fasting blood glucose, high total cholesterol, and high LDL cholesterol levels was age-dependent, these levels were significantly higher in the age group of 30—44 years, and the risk was also significant in the older age groups.
In case of high triglyceride level, an increased risk was found in the age groups 45—59 and 60—74 years. In general, as individuals grow older, the body fat content increases, especially in the abdominal region, which may be the cause of the elevated metabolic risk [ 25 ].
Therefore, screening of abdominal obesity is crucial in the elderly. Furthermore, males were significantly more affected by most of the cardiometabolic parameters, hence it would be fundamental to measure WC particularly in males.
Likewise, the logistic regression model indicated that patients with abdominal obesity had significantly higher odds for high systolic blood pressure, low HDL cholesterol, and high triglyceride levels. Our results are in line with the findings of other researchers [ 26 , 27 ].
In the study of Okosun et al. According to the findings of Huang, WC is a better predictor of insulin resistance [ 28 ] and a better predictor of mortality [ 8 ] than BMI. Furthermore, a strong association has also been documented between abdominal obesity, CVDs, and total mortality [ 27 ].
It is well-known that obesity is strongly related to metabolic, CV, and other diseases [ 29 ]. The health risks of abdominal obesity have already been recognized as well, although WC is still less commonly measured than BMI in the clinical practice [ 8 ].
It is of importance that some individuals with normal BMI are insulin resistant and have metabolic abnormalities, which might contribute to an abnormal fat distribution, especially abdominal obesity [ 30 ].
Obviously, there are differences in the recommendations regarding the screening of obesity in the world. The Obesity Society Guidelines for Managing Overweight and Obesity in Adults do not recommend measuring the WC [ 32 ].
The U. Preventive Services Task Force USPSTF recommends the screening of all adults for obesity by the calculation of the BMI, although it also states that WC may be an acceptable alternative to BMI measurement in some patient subpopulations [ 33 ].
Nonetheless, Hungary has adapted the available evidence that measurement of WC is effective in the prevention of cardiometabolic disorders; thus, according to a decree [ 34 ] regarding screenings done by GPs and financed by the health insurance, measurement of WC is to be included in the physical examination over 21 years of age, and it should be repeated every 5 years.
Despite the existing legal support for screenings in primary health care, the cardiometabolic preventive services are used at much lower rates than recommended for the age group of 21—64 years, and it might contribute to the extremely high CV mortality in Hungary [ 35 ].
In a study performed in a relatively large sample subjects , cardiometabolic risk has been assessed in only The logistic regression model also showed that the risk for elevated LDL cholesterol level was lower in patients with abdominal obesity.
This is consistent with a study [ 37 ] in which it was found that high LDL cholesterol remained relatively unchanged with inreased WC. Possibly, the LDL cholesterol level was modified by cholesterol-lowering therapy, which primarily aims to decrease LDL cholesterol level it is one of the known limitations, see below.
Using the BMI alone to identify metabolic risks, several patients with increased risk but normal BMI would be missed. To measure WC is particularly important above 30 years of age and in males, irrespective of their BMI. The strengths of our study were the large sample size, the measurement of WC by trained health personnel, and the interpretation of the results of a new, innovative model programme in terms of screening in primary care in Hungary.
Our limitations involve that the study was not representative selection bias , and we could not determine cause-and-effect relationships due to the cross-sectional type of this study.
Finally, not all laboratory parameters were available for each subject. In this analysis, we applied the definition of ATP III to classify the patient as having abdominal obesity but data were not analyzed according to International Diabetes Federation IDF thresholds.
As we did not have information on which patients had cholesterol lowering therapy, we could not exclude them from the present analysis, although this therapy might modify the measured LDL cholesterol levels and model calculations based on them.
Our results suggest that screening of abdominal obesity by applying a simple, professionally performed measurement of WC might be a suitable predictor of metabolic syndrome, potentially more practical than, e.
The prevention of metabolic syndrome and the possible outcomes, such as CVDs and diabetes, would be especially beneficial in the Hungarian population, where CVDs are the leading causes of death, and the morbidity of T2DM is continuously increasing. Blüher M. Obesity: global epidemiology and pathogenesis.
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Abdominal obesity, due to intra-abdominal adiposity, meqsurement the progression of Metqbolic Metabolic syndrome abdominal obesity measurement Greek yogurt popsicles factors independently of body measuremet index. This Metabolic syndrome abdominal obesity measurement both through Select secretion of adipocyte-derived biologically active substances adipokinesincluding Metabolic syndrome abdominal obesity measurement fatty acids, adiponectin, interleukin-6, synsrome necrosis factor alpha, and plasminogen activator inhibitor-1, and through exacerbation of insulin resistance and associated Metabilic risk factors. The measruement of abdominal obesity is increasing in western populations, due to a combination of low physical activity and high-energy diets, and also in developing countries, where it is associated with the urbanization of populations. The measurement of waist circumference, together with an additional comorbidity, readily identifies the presence of increased cardiometabolic risk associated with abdominal obesity. Accordingly, measurement of waist circumference should become a standard component of cardiovascular risk evaluation in routine clinical practice. Lifestyle modification remains the initial intervention of choice for this population, with pharmacological modulation of risk factors where this is insufficiently effective. Looking ahead, the initial results of randomized trials with rimonabant, the first CB 1 receptor blocker, indicate the potential of correcting overactivation of the endogenous endocannabinoid system for simultaneous improvement of multiple cardiometabolic risk factors. Adbominal Affiliations: Durand Hospital of EMtabolic Aires Drs Hirschler and Jadzinsky and Messrs Aranda and Maccalini and Citrus fruit varieties of Pharmacy and Biochemistry, University of Buenos Aires Ms de Obesiyt CalcagnoBuenos Aires, Obssity. Objective ,easurement determine in children obezity association between waist circumference WC and insulin resistance determined by homeostasis modeling HOMA-IR and proinsulinemia and components of the metabolic syndrome, including lipid profile and blood pressure BP. Methods Eighty-four students 40 boys aged 6 to 13 years and matched for sex and age underwent anthropometric measurements; 40 were obese; 28, overweight; and 16, nonobese. Body mass index BMIWC, BP, and Tanner stage were determined. An oral glucose tolerance test, lipid profile, and insulin and proinsulin assays were performed. Conclusion Waist circumference is a predictor of insulin resistance syndrome in children and adolescents and could be included in clinical practice as a simple tool to help identify children at risk.
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