Pub Date : 2023-09-30Epub Date: 2023-09-04DOI: 10.7570/jomes23035
Jaejun Lee, Seongjoo Na, Taeyun Kim, Seong-Woo Lee, Myoung Jung Kim, Chang In Han, Si Hyun Bae
Background: Sarcopenia has been associated with nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the correlation between liver fibrosis and muscle mass in young adults with NAFLD.
Methods: We conducted a retrospective review of 88 Korean soldiers <35 years of age who underwent bioelectrical impedance analysis and liver stiffness measurements. A FibroScan-aspartate aminotransferase score >0.35 was used to determine the presence of liver fibrosis.
Results: Among the 88 patients, 38 were classified as having significant fibrosis. In the univariate analysis, muscle mass percentage (MMP), muscle-to-fat ratio (MFR), waist-to-hip ratio (WHR), body mass index, impaired fasting glucose or diabetes mellitus, and alanine transaminase (ALT) level were all significantly associated with fibrosis (P<0.001). After adjusting for ALT level, height, and age, MMP and WHR were associated with fibrosis.
Conclusion: In young adults, MMP and MFR were significantly associated with hepatic fibrosis.
{"title":"Muscle Mass Adjusted for Body Weight Is Associated with Significant Liver Fibrosis in Young Adults with Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study from a Korean Military Hospital.","authors":"Jaejun Lee, Seongjoo Na, Taeyun Kim, Seong-Woo Lee, Myoung Jung Kim, Chang In Han, Si Hyun Bae","doi":"10.7570/jomes23035","DOIUrl":"10.7570/jomes23035","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia has been associated with nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the correlation between liver fibrosis and muscle mass in young adults with NAFLD.</p><p><strong>Methods: </strong>We conducted a retrospective review of 88 Korean soldiers <35 years of age who underwent bioelectrical impedance analysis and liver stiffness measurements. A FibroScan-aspartate aminotransferase score >0.35 was used to determine the presence of liver fibrosis.</p><p><strong>Results: </strong>Among the 88 patients, 38 were classified as having significant fibrosis. In the univariate analysis, muscle mass percentage (MMP), muscle-to-fat ratio (MFR), waist-to-hip ratio (WHR), body mass index, impaired fasting glucose or diabetes mellitus, and alanine transaminase (ALT) level were all significantly associated with fibrosis (<i>P</i><0.001). After adjusting for ALT level, height, and age, MMP and WHR were associated with fibrosis.</p><p><strong>Conclusion: </strong>In young adults, MMP and MFR were significantly associated with hepatic fibrosis.</p>","PeriodicalId":45386,"journal":{"name":"Journal of Obesity & Metabolic Syndrome","volume":" ","pages":"279-283"},"PeriodicalIF":5.2,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/8d/jomes-32-3-279.PMC10583765.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10499790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the latest term for steatotic liver disease associated with metabolic syndrome. MASLD is the most common cause of chronic liver disease and is the leading cause of liver-related morbidity and mortality. It is important that all stakeholders be involved in tackling the public health threat of obesity and obesity-related diseases, including MASLD. A simple and clear assessment and referral pathway using non-invasive tests is essential to ensure that patients with severe MASLD are identified and referred to specialist care, while patients with less severe disease remain in primary care, where they are best managed. While lifestyle intervention is the cornerstone of the management of patients with MASLD, cardiovascular disease risk must be properly assessed and managed because cardiovascular disease is the leading cause of mortality. No pharmacological agent has been approved for the treatment of MASLD, but novel anti-hyperglycemic drugs appear to have benefit. Medications used for the treatment of diabetes and other metabolic conditions may need to be adjusted as liver disease progresses to cirrhosis, especially decompensated cirrhosis. Based on non-invasive tests, the concepts of compensated advanced chronic liver disease and clinically significant portal hypertension provide a practical approach to stratifying patients according to the risk of liver-related complications and can help manage such patients. Finally, prevention and management of sarcopenia should be considered in the management of patients with MASLD.
{"title":"Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A State-of-the-Art Review.","authors":"Wah-Kheong Chan, Kee-Huat Chuah, Ruveena Bhavani Rajaram, Lee-Ling Lim, Jeyakantha Ratnasingam, Shireene Ratna Vethakkan","doi":"10.7570/jomes23052","DOIUrl":"10.7570/jomes23052","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the latest term for steatotic liver disease associated with metabolic syndrome. MASLD is the most common cause of chronic liver disease and is the leading cause of liver-related morbidity and mortality. It is important that all stakeholders be involved in tackling the public health threat of obesity and obesity-related diseases, including MASLD. A simple and clear assessment and referral pathway using non-invasive tests is essential to ensure that patients with severe MASLD are identified and referred to specialist care, while patients with less severe disease remain in primary care, where they are best managed. While lifestyle intervention is the cornerstone of the management of patients with MASLD, cardiovascular disease risk must be properly assessed and managed because cardiovascular disease is the leading cause of mortality. No pharmacological agent has been approved for the treatment of MASLD, but novel anti-hyperglycemic drugs appear to have benefit. Medications used for the treatment of diabetes and other metabolic conditions may need to be adjusted as liver disease progresses to cirrhosis, especially decompensated cirrhosis. Based on non-invasive tests, the concepts of compensated advanced chronic liver disease and clinically significant portal hypertension provide a practical approach to stratifying patients according to the risk of liver-related complications and can help manage such patients. Finally, prevention and management of sarcopenia should be considered in the management of patients with MASLD.</p>","PeriodicalId":45386,"journal":{"name":"Journal of Obesity & Metabolic Syndrome","volume":" ","pages":"197-213"},"PeriodicalIF":4.7,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/ad/jomes-32-3-197.PMC10583766.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10572169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Han Na Jung, Sehee Kim, Chang Hee Jung, Yun Kyung Cho
Background: The association between body mass index (BMI) and mortality in patients with type 1 diabetes mellitus (T1DM) has been poorly examined and has never been systematically reviewed. This meta-analysis investigated the all-cause mortality risk for each BMI category among patients with T1DM.
Methods: A systematic literature review of the PubMed, Embase, and Cochrane Library databases was performed in July 2022. Cohort studies comparing the mortality risk between BMI categories among patients with T1DM were eligible. Pooled hazard ratios (HRs) for all-cause mortality among underweight (BMI <18.5 kg/m2), overweight (BMI, 25 to <30 kg/m2), and obese (BMI ≥30 kg/m2) individuals were calculated in reference to the normal-weight group (BMI, 18.5 to <25 kg/m2). The Newcastle-Ottawa Scale was used to assess the risk of bias.
Results: Three prospective studies involving 23,407 adults were included. The underweight group was shown to have a 3.4 times greater risk of mortality than the normal-weight group (95% confidence interval [CI], 1.67 to 6.85). Meanwhile, there was no significant difference in mortality risk between the normal-weight group and the overweight group (HR, 0.90; 95% CI, 0.66 to 1.22) or the obese group (HR, 1.36; 95% CI, 0.86 to 2.15), possibly due to the heterogeneous results of these BMI categories among the included studies.
Conclusion: Underweight patients with T1DM had a significantly greater risk of all-cause mortality than their normal-weight counterparts. Overweight and obese patients showed heterogeneous risks across the studies. Further prospective studies on patients with T1DM are required to establish weight management guidelines.
{"title":"Association between Body Mass Index and Mortality in Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis.","authors":"Han Na Jung, Sehee Kim, Chang Hee Jung, Yun Kyung Cho","doi":"10.7570/jomes22061","DOIUrl":"https://doi.org/10.7570/jomes22061","url":null,"abstract":"<p><strong>Background: </strong>The association between body mass index (BMI) and mortality in patients with type 1 diabetes mellitus (T1DM) has been poorly examined and has never been systematically reviewed. This meta-analysis investigated the all-cause mortality risk for each BMI category among patients with T1DM.</p><p><strong>Methods: </strong>A systematic literature review of the PubMed, Embase, and Cochrane Library databases was performed in July 2022. Cohort studies comparing the mortality risk between BMI categories among patients with T1DM were eligible. Pooled hazard ratios (HRs) for all-cause mortality among underweight (BMI <18.5 kg/m<sup>2</sup>), overweight (BMI, 25 to <30 kg/m<sup>2</sup>), and obese (BMI ≥30 kg/m<sup>2</sup>) individuals were calculated in reference to the normal-weight group (BMI, 18.5 to <25 kg/m<sup>2</sup>). The Newcastle-Ottawa Scale was used to assess the risk of bias.</p><p><strong>Results: </strong>Three prospective studies involving 23,407 adults were included. The underweight group was shown to have a 3.4 times greater risk of mortality than the normal-weight group (95% confidence interval [CI], 1.67 to 6.85). Meanwhile, there was no significant difference in mortality risk between the normal-weight group and the overweight group (HR, 0.90; 95% CI, 0.66 to 1.22) or the obese group (HR, 1.36; 95% CI, 0.86 to 2.15), possibly due to the heterogeneous results of these BMI categories among the included studies.</p><p><strong>Conclusion: </strong>Underweight patients with T1DM had a significantly greater risk of all-cause mortality than their normal-weight counterparts. Overweight and obese patients showed heterogeneous risks across the studies. Further prospective studies on patients with T1DM are required to establish weight management guidelines.</p>","PeriodicalId":45386,"journal":{"name":"Journal of Obesity & Metabolic Syndrome","volume":"32 2","pages":"151-162"},"PeriodicalIF":5.2,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/ac/jomes-32-2-151.PMC10327680.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10138273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: High body weight variability (BWV) is associated with many metabolic and cardiovascular diseases in adults. The study was designed to explore the baseline characteristics associated with high BWV.
Methods: Using a nationally representative database from the Korean National Health Insurance system, 77,424 individuals who underwent five health examinations between 2009 and 2013 were enrolled. BWV was calculated using the body weight recorded at each examination, and the clinical and demographic characteristics associated with high BWV were investigated. High BWV was defined as the highest quartile of coefficient variation in body weight.
Results: Subjects with high BWV were younger, more commonly female, less likely to have a high income, and more likely to be a current smoker. Young people under the age of 40 years were more than twice as likely to have high BWV compared with those over 65 years (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.88 to 2.50). The incidence of high BWV was higher in female than in male (OR, 1.67; 95% CI, 1.59 to 1.76). Male with the lowest income had a 1.9-fold higher risk of high BWV compared to male with the highest income (OR, 1.97; 95% CI, 1.81 to 2.13). A high BWV in female was associated with heavy alcohol intake (OR, 1.50; 95% CI, 1.17 to 1.91) and current smoking (OR, 1.97; 95% CI, 1.67 to 2.33).
Conclusion: Young people, female, low income, and unhealthy behaviors were independently associated with high BWV. Further research is needed on the mechanisms linking high BWV to detrimental health outcomes.
{"title":"Factors Affecting High Body Weight Variability.","authors":"Kyungdo Han, Mee Kyoung Kim","doi":"10.7570/jomes22063","DOIUrl":"https://doi.org/10.7570/jomes22063","url":null,"abstract":"<p><strong>Background: </strong>High body weight variability (BWV) is associated with many metabolic and cardiovascular diseases in adults. The study was designed to explore the baseline characteristics associated with high BWV.</p><p><strong>Methods: </strong>Using a nationally representative database from the Korean National Health Insurance system, 77,424 individuals who underwent five health examinations between 2009 and 2013 were enrolled. BWV was calculated using the body weight recorded at each examination, and the clinical and demographic characteristics associated with high BWV were investigated. High BWV was defined as the highest quartile of coefficient variation in body weight.</p><p><strong>Results: </strong>Subjects with high BWV were younger, more commonly female, less likely to have a high income, and more likely to be a current smoker. Young people under the age of 40 years were more than twice as likely to have high BWV compared with those over 65 years (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.88 to 2.50). The incidence of high BWV was higher in female than in male (OR, 1.67; 95% CI, 1.59 to 1.76). Male with the lowest income had a 1.9-fold higher risk of high BWV compared to male with the highest income (OR, 1.97; 95% CI, 1.81 to 2.13). A high BWV in female was associated with heavy alcohol intake (OR, 1.50; 95% CI, 1.17 to 1.91) and current smoking (OR, 1.97; 95% CI, 1.67 to 2.33).</p><p><strong>Conclusion: </strong>Young people, female, low income, and unhealthy behaviors were independently associated with high BWV. Further research is needed on the mechanisms linking high BWV to detrimental health outcomes.</p>","PeriodicalId":45386,"journal":{"name":"Journal of Obesity & Metabolic Syndrome","volume":"32 2","pages":"163-169"},"PeriodicalIF":5.2,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/5e/jomes-32-2-163.PMC10327685.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9764439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J Obes Metab Syndr 2023;32:103-105 Metabolic syndrome (MetS) is an emerging burden associated with significant morbidity and mortality in children and adolescents. In recent decades, the prevalence of obesity has continually increased both worldwide and in Korea.1,2 Trends in mean body mass index (BMI) have recently flattened for both boys and girls in northwestern Europe and Asia-Pacific regions, for boys in southwestern Europe, and for girls in central and Latin America.1 In contrast, the rise in BMI has accelerated for both boys and girls in east and South Asia, and for boys in Southeast Asia.1 Pediatric obesity is often accompanied by MetS. Consequently, accurate evaluation of obesity in children and adolescents is of significant interest because it may result in adulthood obesity and comorbid conditions such as cardiovascular disease, obstructive sleep apnea, insulin resistance, non-alcoholic fatty liver disease, and dyslipidemia.3,4 More than half of all obese children have two or more complications. The definition of MetS by the modified criteria of the National Cholesterol Education Program-Adult Treatment Panel III must include at least three of five criteria: central obesity above the 90th percentile, fasting glucose above 110 mg/dL, hypertriglycerides above 110 mg/dL, low high density lipoprotein cholesterol below 40 mg/dL, and hypertension above the 90th percentile or receiving treatment for hypertension.1 Based on the criteria of the International Diabetes Federation, MetS is a combination of central obesity with the presence of two or more of the other four risk factors.5 According to International Diabetes Federation guidelines, children younger than 6 years are excluded from the definition due to limited data for this age group. MetS cannot be diagnosed at the age of 6 to 10 years. However, additional testing should be performed if there is a family history of MetS, type 2 diabetes mellitus, dyslipidemia, cardiovascular disease, hypertension, or obesity.6 Most studies are based on baseline BMI measurements to evaluate excessive adiposity in humans. BMI is a limited indicator of pediatric metabolic risk due to the paucity of data in this population.7 Waist circumference (WC) and waist-height ratio (WHtR) are helpful measures of central adiposity in both clinical and research settings.8 WC has emerged as an index of pediatric adiposity that predicts fat mass as effectively as or better than BMI.8 Moreover, WC has been shown to be effective in estimating total adiposity, which is strongly linked to intra-abdominal fat. Several studies have investigated the prevalence of abdominal obesity in children and adolescents and report that it ranges from 9.7% to 11.5% in Korea.9-11 Compared with previous studies,9-11 the
{"title":"The Prevalence of Abdominal Obesity and Metabolic Syndrome in Korean Children and Adolescents.","authors":"Ja Hyang Cho","doi":"10.7570/jomes23025","DOIUrl":"https://doi.org/10.7570/jomes23025","url":null,"abstract":"J Obes Metab Syndr 2023;32:103-105 Metabolic syndrome (MetS) is an emerging burden associated with significant morbidity and mortality in children and adolescents. In recent decades, the prevalence of obesity has continually increased both worldwide and in Korea.1,2 Trends in mean body mass index (BMI) have recently flattened for both boys and girls in northwestern Europe and Asia-Pacific regions, for boys in southwestern Europe, and for girls in central and Latin America.1 In contrast, the rise in BMI has accelerated for both boys and girls in east and South Asia, and for boys in Southeast Asia.1 Pediatric obesity is often accompanied by MetS. Consequently, accurate evaluation of obesity in children and adolescents is of significant interest because it may result in adulthood obesity and comorbid conditions such as cardiovascular disease, obstructive sleep apnea, insulin resistance, non-alcoholic fatty liver disease, and dyslipidemia.3,4 More than half of all obese children have two or more complications. The definition of MetS by the modified criteria of the National Cholesterol Education Program-Adult Treatment Panel III must include at least three of five criteria: central obesity above the 90th percentile, fasting glucose above 110 mg/dL, hypertriglycerides above 110 mg/dL, low high density lipoprotein cholesterol below 40 mg/dL, and hypertension above the 90th percentile or receiving treatment for hypertension.1 Based on the criteria of the International Diabetes Federation, MetS is a combination of central obesity with the presence of two or more of the other four risk factors.5 According to International Diabetes Federation guidelines, children younger than 6 years are excluded from the definition due to limited data for this age group. MetS cannot be diagnosed at the age of 6 to 10 years. However, additional testing should be performed if there is a family history of MetS, type 2 diabetes mellitus, dyslipidemia, cardiovascular disease, hypertension, or obesity.6 Most studies are based on baseline BMI measurements to evaluate excessive adiposity in humans. BMI is a limited indicator of pediatric metabolic risk due to the paucity of data in this population.7 Waist circumference (WC) and waist-height ratio (WHtR) are helpful measures of central adiposity in both clinical and research settings.8 WC has emerged as an index of pediatric adiposity that predicts fat mass as effectively as or better than BMI.8 Moreover, WC has been shown to be effective in estimating total adiposity, which is strongly linked to intra-abdominal fat. Several studies have investigated the prevalence of abdominal obesity in children and adolescents and report that it ranges from 9.7% to 11.5% in Korea.9-11 Compared with previous studies,9-11 the","PeriodicalId":45386,"journal":{"name":"Journal of Obesity & Metabolic Syndrome","volume":"32 2","pages":"103-105"},"PeriodicalIF":5.2,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/f2/jomes-32-2-103.PMC10327683.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9764450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J Obes Metab Syndr 2023;32:179-180 Cardiovascular diseases (CVDs) are the most common cause of physical disability and mortality globally1 and the second leading cause of death in Korea.2 Hence, determining predictors of CVD is crucial to promoting human health. Currently, traditional cardiovascular (CV) risk factors are used in CVD prediction models.3 In addition to diabetes mellitus (DM), insulin resistance is the fundamental etiology of atherosclerotic CVD and is used to predict CVD in both people with and without DM.4 The gold standard for diagnosis of insulin resistance is the euglycemic insulin clamp technique; however, this method is complex, invasive, and costly.5 The homeostasis model assessment-estimated insulin resistance index is widely used owing to its convenience; only one blood sample is required. However, it has the following drawbacks: (1) blood insulin concentration must be measured; (2) it cannot be used for individuals receiving insulin therapy; and (3) it is inaccurate in patients with DM with diminished beta-cell function.6 The triglyceride-glucose (TyG) index overcomes these drawbacks. It is calculated using fasting glucose and triglyceride levels and can be used to indicate insulin resistance in people with and without DM.7 Cho et al.8 classified 292,206 participants of the Korean National Health Insurance Service National Health Screening Cohort into four groups (metabolically healthy non-obese, metabolically unhealthy non-obese, metabolically healthy obese [MHO], and metabolically unhealthy obese [MUO]) that were followed from 2009 to 2015. The baseline TyG index was found to be correlated with CV events and CV mortality in the MUO group. However, this study analyzed the correlation between baseline TyG index and the incidence of CVD over 6 years of follow-up. Changes in the TyG index during the follow-up period may have influenced the gradual onset of CVD. Therefore, predicting CVD based on TyG index taken at one time point may be inaccurate and vulnerable to regression dilution biases.9 Furthermore, Cho et al.8 divided the participants into groups based on obesity and metabolic health at baseline to investigate CV events and mortality throughout the follow-up period. Obesity and metabolic health also change over time. Soriguer et al.10 reported that many study participants progressed from MHO to MUO during a 6or 11-year of follow-up. Furthermore, the incidence of type 2 DM decreased among individuals who lost weight during the follow-up period. Thus, obesity and metabolic health are dynamic and change over time, and ultimately,
{"title":"Letter: Triglyceride-Glucose Index Predicts Cardiovascular Outcome in Metabolically Unhealthy Obese Population: A Nationwide Population-Based Cohort Study (J Obes Metab Syndr 2022;31:178-86).","authors":"Gwanpyo Koh","doi":"10.7570/jomes23017","DOIUrl":"https://doi.org/10.7570/jomes23017","url":null,"abstract":"J Obes Metab Syndr 2023;32:179-180 Cardiovascular diseases (CVDs) are the most common cause of physical disability and mortality globally1 and the second leading cause of death in Korea.2 Hence, determining predictors of CVD is crucial to promoting human health. Currently, traditional cardiovascular (CV) risk factors are used in CVD prediction models.3 In addition to diabetes mellitus (DM), insulin resistance is the fundamental etiology of atherosclerotic CVD and is used to predict CVD in both people with and without DM.4 The gold standard for diagnosis of insulin resistance is the euglycemic insulin clamp technique; however, this method is complex, invasive, and costly.5 The homeostasis model assessment-estimated insulin resistance index is widely used owing to its convenience; only one blood sample is required. However, it has the following drawbacks: (1) blood insulin concentration must be measured; (2) it cannot be used for individuals receiving insulin therapy; and (3) it is inaccurate in patients with DM with diminished beta-cell function.6 The triglyceride-glucose (TyG) index overcomes these drawbacks. It is calculated using fasting glucose and triglyceride levels and can be used to indicate insulin resistance in people with and without DM.7 Cho et al.8 classified 292,206 participants of the Korean National Health Insurance Service National Health Screening Cohort into four groups (metabolically healthy non-obese, metabolically unhealthy non-obese, metabolically healthy obese [MHO], and metabolically unhealthy obese [MUO]) that were followed from 2009 to 2015. The baseline TyG index was found to be correlated with CV events and CV mortality in the MUO group. However, this study analyzed the correlation between baseline TyG index and the incidence of CVD over 6 years of follow-up. Changes in the TyG index during the follow-up period may have influenced the gradual onset of CVD. Therefore, predicting CVD based on TyG index taken at one time point may be inaccurate and vulnerable to regression dilution biases.9 Furthermore, Cho et al.8 divided the participants into groups based on obesity and metabolic health at baseline to investigate CV events and mortality throughout the follow-up period. Obesity and metabolic health also change over time. Soriguer et al.10 reported that many study participants progressed from MHO to MUO during a 6or 11-year of follow-up. Furthermore, the incidence of type 2 DM decreased among individuals who lost weight during the follow-up period. Thus, obesity and metabolic health are dynamic and change over time, and ultimately,","PeriodicalId":45386,"journal":{"name":"Journal of Obesity & Metabolic Syndrome","volume":"32 2","pages":"179-180"},"PeriodicalIF":5.2,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c1/19/jomes-32-2-179.PMC10327687.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yun Kyung Cho, Hwi Seung Kim, Joong-Yeol Park, Woo Je Lee, Ye-Jee Kim, Chang Hee Jung
J Obes Metab Syndr 2023;32:181-182 The triglyceride glucose (TyG) index is considered a surrogate marker of cardiovascular disease (CVD) and mortality using the parameter of insulin resistance. Numerous studies have investigated the associations between the TyG index and cardiovascular outcomes, including cardiovascular mortality. A recent meta-analysis and systematic review evaluated associations between the TyG index and the risks of CVD and mortality in the general population.1 Twelve cohort studies involving 6,354,990 participants were analyzed. Higher TyG index values were significantly associated with an increased incidence of CVD; however, the TyG index was not correlated with mortality, including cardiovascular mortality in analyses.1 A subgroup analysis of the population without diabetes revealed no significant association between myocardial infarction incidence and the TyG index, indicating the heterogeneous implications of this index across populations.2 The present study contributes to the literature because we focused on the specific population in which the TyG index could be a useful surrogate marker for an elevated CVD risk.3 Our results demonstrated that the TyG index could predict CVD mortality only in participants with metabolically unhealthy obesity (MUO), and that the index is substantially and consistently associated with CVD regardless of the metabolic health phenotype or presence of obesity.3 In a letter to the editor, the author stated that assessing the predictive value of the TyG index for CVD outcomes would provide greater benefit if we considered changes in the TyG index as well as the obese metabolic health phenotype. Several recent studies have reported the significant effect of longitudinal changes in the TyG index on CVD risk. We appreciate the letter author for highlighting these important points. A study involving 62,443 healthy Chinese people found that CVD risk increased with quartile of change in the TyG index during a median follow-up of 7.01 years, and that adding change in the TyG index to a baseline risk model for CVD improved its predictive power.4 Another prospective cohort study involving 36,359 participants with a median observation period of
{"title":"Response: Triglyceride-Glucose Index Predicts Cardiovascular Outcome in Metabolically Unhealthy Obese Population: A Nationwide Population-Based Cohort Study (J Obes Metab Syndr 2022;31:178-86).","authors":"Yun Kyung Cho, Hwi Seung Kim, Joong-Yeol Park, Woo Je Lee, Ye-Jee Kim, Chang Hee Jung","doi":"10.7570/jomes23019","DOIUrl":"https://doi.org/10.7570/jomes23019","url":null,"abstract":"J Obes Metab Syndr 2023;32:181-182 The triglyceride glucose (TyG) index is considered a surrogate marker of cardiovascular disease (CVD) and mortality using the parameter of insulin resistance. Numerous studies have investigated the associations between the TyG index and cardiovascular outcomes, including cardiovascular mortality. A recent meta-analysis and systematic review evaluated associations between the TyG index and the risks of CVD and mortality in the general population.1 Twelve cohort studies involving 6,354,990 participants were analyzed. Higher TyG index values were significantly associated with an increased incidence of CVD; however, the TyG index was not correlated with mortality, including cardiovascular mortality in analyses.1 A subgroup analysis of the population without diabetes revealed no significant association between myocardial infarction incidence and the TyG index, indicating the heterogeneous implications of this index across populations.2 The present study contributes to the literature because we focused on the specific population in which the TyG index could be a useful surrogate marker for an elevated CVD risk.3 Our results demonstrated that the TyG index could predict CVD mortality only in participants with metabolically unhealthy obesity (MUO), and that the index is substantially and consistently associated with CVD regardless of the metabolic health phenotype or presence of obesity.3 In a letter to the editor, the author stated that assessing the predictive value of the TyG index for CVD outcomes would provide greater benefit if we considered changes in the TyG index as well as the obese metabolic health phenotype. Several recent studies have reported the significant effect of longitudinal changes in the TyG index on CVD risk. We appreciate the letter author for highlighting these important points. A study involving 62,443 healthy Chinese people found that CVD risk increased with quartile of change in the TyG index during a median follow-up of 7.01 years, and that adding change in the TyG index to a baseline risk model for CVD improved its predictive power.4 Another prospective cohort study involving 36,359 participants with a median observation period of","PeriodicalId":45386,"journal":{"name":"Journal of Obesity & Metabolic Syndrome","volume":"32 2","pages":"181-182"},"PeriodicalIF":5.2,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/21/64/jomes-32-2-181.PMC10327682.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9764449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Min Jeong Park, Soon Young Hwang, Nam Hoon Kim, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Hye Jin Yoo
Background: As the metabolic significance of sarcopenic obesity (SO) is revealed, finding an appropriate index to detect SO is important, especially for type 2 diabetes mellitus (T2DM) patients with accompanying metabolic dysfunction.
Methods: Participants (n=515) from the Korea Guro Diabetes Program were included to compare how well waist circumference (WC), waist hip ratio (WHR), waist height ratio (WHtR), and the weight-adjusted waist index (WWI) predict SO in newly diagnosed T2DM patients. Sarcopenia was defined based on guidelines from the 2019 Asian Working Group for Sarcopenia as both low muscle mass (appendicular skeletal muscle [ASM]/height2 <7.0 kg/m2 for men, <5.4 kg/m2 for women) and strength (handgrip strength <28.0 kg for men, <18.0 kg for women) and/or reduced physical performance (gait speed <1.0 m/sec). Obesity was defined as a WC ≥90 cm in men and ≥85 cm in women. The WHR, WHtR, and WWI were calculated by dividing the WC by the hip circumference, height, and √ weight, respectively.
Results: The WC, WHR, and WHtR correlated positively with the fat and muscle mass represented by truncal fat amount (TFA) and ASM, whereas the WWI was proportional to the TFA and inversely related to ASM. Of the four indices, the WWI showed the highest area under the receiver operative characteristic curve for SO. The WWI also exhibited a positive correlation with albuminuria and the mean brachial-ankle pulse wave velocity, especially in patients aged ≥65 years.
Conclusion: The WWI is the preferable anthropometric index for predicting SO in T2DM patients, and it might be a proper index for predicting cardiometabolic risk factors in elderly people.
{"title":"A Novel Anthropometric Parameter, Weight-Adjusted Waist Index Represents Sarcopenic Obesity in Newly Diagnosed Type 2 Diabetes Mellitus.","authors":"Min Jeong Park, Soon Young Hwang, Nam Hoon Kim, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Hye Jin Yoo","doi":"10.7570/jomes23005","DOIUrl":"https://doi.org/10.7570/jomes23005","url":null,"abstract":"<p><strong>Background: </strong>As the metabolic significance of sarcopenic obesity (SO) is revealed, finding an appropriate index to detect SO is important, especially for type 2 diabetes mellitus (T2DM) patients with accompanying metabolic dysfunction.</p><p><strong>Methods: </strong>Participants (n=515) from the Korea Guro Diabetes Program were included to compare how well waist circumference (WC), waist hip ratio (WHR), waist height ratio (WHtR), and the weight-adjusted waist index (WWI) predict SO in newly diagnosed T2DM patients. Sarcopenia was defined based on guidelines from the 2019 Asian Working Group for Sarcopenia as both low muscle mass (appendicular skeletal muscle [ASM]/height<sup>2</sup> <7.0 kg/m<sup>2</sup> for men, <5.4 kg/m<sup>2</sup> for women) and strength (handgrip strength <28.0 kg for men, <18.0 kg for women) and/or reduced physical performance (gait speed <1.0 m/sec). Obesity was defined as a WC ≥90 cm in men and ≥85 cm in women. The WHR, WHtR, and WWI were calculated by dividing the WC by the hip circumference, height, and √ weight, respectively.</p><p><strong>Results: </strong>The WC, WHR, and WHtR correlated positively with the fat and muscle mass represented by truncal fat amount (TFA) and ASM, whereas the WWI was proportional to the TFA and inversely related to ASM. Of the four indices, the WWI showed the highest area under the receiver operative characteristic curve for SO. The WWI also exhibited a positive correlation with albuminuria and the mean brachial-ankle pulse wave velocity, especially in patients aged ≥65 years.</p><p><strong>Conclusion: </strong>The WWI is the preferable anthropometric index for predicting SO in T2DM patients, and it might be a proper index for predicting cardiometabolic risk factors in elderly people.</p>","PeriodicalId":45386,"journal":{"name":"Journal of Obesity & Metabolic Syndrome","volume":"32 2","pages":"130-140"},"PeriodicalIF":5.2,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/31/jomes-32-2-130.PMC10327688.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9751926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jieun Lee, Sung-Chan Kang, Obin Kwon, Seung-Sik Hwang, Jin Soo Moon, Hyun Wook Chae, Jaehyun Kim
Background: The prevalence of obesity in children and adolescents is increasing worldwide, which is of concern because obesity can lead to various complications such as metabolic syndrome (MS). Waist circumference (WC) and waist-height ratio (WHtR) are useful indicators of abdominal obesity and MS. In this study, we investigate trends in the prevalence of abdominal obesity and MS using two different references.
Methods: Data from the Korea National Health and Nutrition Examination Survey (2007 to 2020) were used. In total, 21,652 participants aged 2 to 18 years and 9,592 participants aged 10 to 18 years were analyzed for abdominal obesity and MS, respectively. The prevalence of abdominal obesity and that of MS were compared using the Korean National Growth Chart in 2007 (REF2007) and the newly published WC and WHtR reference values in 2022 (REF2022).
Results: Both WC and WHtR showed an increasing trend. The prevalence of abdominal obesity was 14.71% based on REF2022, 5.85% points higher than that of 8.86% based on REF2007. MS based on REF2022 had a higher prevalence for both the National Cholesterol Education Program definition (3.90% by REF2007, 4.78% by REF2022) and the International Diabetes Federation definition (2.29% by REF2007, 3.10% by REF2022). The prevalence of both abdominal obesity and MS increased over time.
Conclusion: The prevalence of abdominal obesity and MS increased in Korean children and adolescents from 2007 to 2020. When analyzed by REF2022, both abdominal obesity and MS showed higher prevalence rates than when using REF2007, indicating that previous reports were underestimated. Follow-up for abdominal obesity and MS using REF2022 is needed.
{"title":"Temporal Trends of the Prevalence of Abdominal Obesity and Metabolic Syndrome in Korean Children and Adolescents between 2007 and 2020.","authors":"Jieun Lee, Sung-Chan Kang, Obin Kwon, Seung-Sik Hwang, Jin Soo Moon, Hyun Wook Chae, Jaehyun Kim","doi":"10.7570/jomes22059","DOIUrl":"https://doi.org/10.7570/jomes22059","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of obesity in children and adolescents is increasing worldwide, which is of concern because obesity can lead to various complications such as metabolic syndrome (MS). Waist circumference (WC) and waist-height ratio (WHtR) are useful indicators of abdominal obesity and MS. In this study, we investigate trends in the prevalence of abdominal obesity and MS using two different references.</p><p><strong>Methods: </strong>Data from the Korea National Health and Nutrition Examination Survey (2007 to 2020) were used. In total, 21,652 participants aged 2 to 18 years and 9,592 participants aged 10 to 18 years were analyzed for abdominal obesity and MS, respectively. The prevalence of abdominal obesity and that of MS were compared using the Korean National Growth Chart in 2007 (REF2007) and the newly published WC and WHtR reference values in 2022 (REF2022).</p><p><strong>Results: </strong>Both WC and WHtR showed an increasing trend. The prevalence of abdominal obesity was 14.71% based on REF2022, 5.85% points higher than that of 8.86% based on REF2007. MS based on REF2022 had a higher prevalence for both the National Cholesterol Education Program definition (3.90% by REF2007, 4.78% by REF2022) and the International Diabetes Federation definition (2.29% by REF2007, 3.10% by REF2022). The prevalence of both abdominal obesity and MS increased over time.</p><p><strong>Conclusion: </strong>The prevalence of abdominal obesity and MS increased in Korean children and adolescents from 2007 to 2020. When analyzed by REF2022, both abdominal obesity and MS showed higher prevalence rates than when using REF2007, indicating that previous reports were underestimated. Follow-up for abdominal obesity and MS using REF2022 is needed.</p>","PeriodicalId":45386,"journal":{"name":"Journal of Obesity & Metabolic Syndrome","volume":"32 2","pages":"170-178"},"PeriodicalIF":5.2,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/70/b2/jomes-32-2-170.PMC10327689.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Some epidemiologic factors and body mass index (BMI) have site-specific effects on gastric cancer. The site-specific effect of high-density lipoprotein cholesterol (HDL-C) and hyperglycemia on gastric cancer has not been reported.
Methods: This study included adults who underwent national gastric cancer screening in 2011 (n=5.49 million). The validation set included gastric cancer patients (n=3,262) and gastric cancer-free persons who underwent health screening (n=14,121) in a single hospital. The site-specific effects of metabolic components and epidemiologic factors on gastric cancer were investigated.
Results: Among 5.49 million individuals, 10,417 gastric cancer cases (6,764 non-cardiac gastric cancer [NCGC] and 152 cardiac gastric cancer [CGC]) were detected. BMI was inversely associated with NCGC (P for trend <0.001) but not with CGC. Low HDL-C was associated with both CGC (adjusted odds ratio [aOR], 1.90; 95% confidence interval [CI], 1.34 to 2.71) and NCGC (aOR, 1.41; 95% CI, 1.34 to 1.49). Fasting glucose ≥110 mg/dL was associated with NCGC (aOR, 1.19) and CGC (aOR, 1.50). Men predominance was larger in CGC (aOR, 3.28) than in NCGC (aOR, 1.98). Smoking, alcohol drinking, and family history were associated with NCGC but not with CGC. In the validation set, low HDL-C was associated with CGC (aOR, 2.80) and NCGC (aOR, 2.32). BMI was inversely associated with NCGC (P for trend <0.001), and hyperglycemia was positively associated with both NCGC and CGC.
Conclusion: Many epidemiologic factors had site-specific effects on gastric cancer, whereas low HDL-C and hyperglycemia were constantly associated with gastric cancer regardless of the site in two independent sets.
{"title":"Constant Association between Low High-Density Lipoprotein Cholesterol and Gastric Cancer Regardless of Site.","authors":"Su Youn Nam, Jihyeon Jeong, Seong Woo Jeon","doi":"10.7570/jomes22045","DOIUrl":"https://doi.org/10.7570/jomes22045","url":null,"abstract":"<p><strong>Background: </strong>Some epidemiologic factors and body mass index (BMI) have site-specific effects on gastric cancer. The site-specific effect of high-density lipoprotein cholesterol (HDL-C) and hyperglycemia on gastric cancer has not been reported.</p><p><strong>Methods: </strong>This study included adults who underwent national gastric cancer screening in 2011 (n=5.49 million). The validation set included gastric cancer patients (n=3,262) and gastric cancer-free persons who underwent health screening (n=14,121) in a single hospital. The site-specific effects of metabolic components and epidemiologic factors on gastric cancer were investigated.</p><p><strong>Results: </strong>Among 5.49 million individuals, 10,417 gastric cancer cases (6,764 non-cardiac gastric cancer [NCGC] and 152 cardiac gastric cancer [CGC]) were detected. BMI was inversely associated with NCGC (<i>P</i> for trend <0.001) but not with CGC. Low HDL-C was associated with both CGC (adjusted odds ratio [aOR], 1.90; 95% confidence interval [CI], 1.34 to 2.71) and NCGC (aOR, 1.41; 95% CI, 1.34 to 1.49). Fasting glucose ≥110 mg/dL was associated with NCGC (aOR, 1.19) and CGC (aOR, 1.50). Men predominance was larger in CGC (aOR, 3.28) than in NCGC (aOR, 1.98). Smoking, alcohol drinking, and family history were associated with NCGC but not with CGC. In the validation set, low HDL-C was associated with CGC (aOR, 2.80) and NCGC (aOR, 2.32). BMI was inversely associated with NCGC (<i>P</i> for trend <0.001), and hyperglycemia was positively associated with both NCGC and CGC.</p><p><strong>Conclusion: </strong>Many epidemiologic factors had site-specific effects on gastric cancer, whereas low HDL-C and hyperglycemia were constantly associated with gastric cancer regardless of the site in two independent sets.</p>","PeriodicalId":45386,"journal":{"name":"Journal of Obesity & Metabolic Syndrome","volume":"32 2","pages":"141-150"},"PeriodicalIF":5.2,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/f4/jomes-32-2-141.PMC10327681.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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