OBJECTIVE: We aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults. METHODS: Adults ≥ 65 years old ( n = 1,973) were interviewed at baseline in 2018 and 1,459 were followed up in 2021. General and abdominal obesity were assessed, and serum C-reactive protein (CRP) levels were measured at baseline. Depression status was assessed at baseline and at follow-up. Logistic regression was used to analyze the relationship between obesity and the incidence of depression and worsening of depressive symptoms, as well as the relationship between obesity and CRP levels. The associations of CRP levels with the geriatric depression scale, as well as with its three dimensions, were investigated using multiple linear regressions. RESULTS: General obesity was associated with worsening depression symptoms and incident depression, with an odds ratio ( OR) [95% confidence interval ( CI)] of 1.53 (1.13-2.12) and 1.80 (1.23-2.63), especially among old male subjects, with OR (95% CI) of 2.12 (1.25-3.58) and 2.24 (1.22-4.11), respectively; however, no significant relationship was observed between abdominal obesity and depression. In addition, general obesity was associated with high levels of CRP, with OR (95% CI) of 2.58 (1.75-3.81), especially in subjects free of depression at baseline, with OR (95% CI) of 3.15 (1.97-5.04), and CRP levels were positively correlated with a score of specific dimension (life satisfaction) of depression, P < 0.05. CONCLUSION General obesity, rather than abdominal obesity, was associated with worsening depressive symptoms and incident depression, which can be partly explained by the systemic inflammatory response, and the impact of obesity on depression should be taken more seriously in the older male population.
Humans ; Male ; Aged ; Depression/etiology* ; C-Reactive Protein/metabolism* ; Obesity, Abdominal/epidemiology* ; Longitudinal Studies ; Inflammation/epidemiology* ; Obesity/complications*

Asian Continental Ancestry Group ; Body Weight ; China ; epidemiology ; Humans ; Obesity ; classification ; epidemiology ; metabolism

OBJECTIVEThe incidences of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) are very high in obese children, and insulin resistance may be the key point linking them together. Debates still remain as to whether NAFLD could be a component of MS. Some researchers reported that NAFLD was a composition of MS, while the others stated that NAFLD was an independent predicting factor of MS. Here we analyzed the prevalence of NAFLD and MS in 308 obese children who came to our endocrinology department from June 2003 to September 2006, and we also evaluated the relationship between NAFLD and MS in this group of obese children.

METHODTotally 308 obese children aged from 9 to 14 years with mean age of (10.7 +/- 2.6) years were enrolled. Two hundred and thirty one were males, and 77 were females. Body mass index (BMI), waist circumference (WC), biochemical indicators, liver B-mode ultrasound examination, oral glucose tolerance test (OGTT) and insulin releasing test were performed for all of the cases. The incidences of NAFLD including simple nonalcoholic fatty liver (SNAFL) and nonalcoholic steatohepatitis (NASH) as well as MS were calculated. Three subgroups were selected according to the diagnostic criteria: Group 1: OCWLD (obese children without liver disorder), Group 2: SNAFL and Group 3: NASH. The prevalence of MS, components of MS, free insulin, whole body insulin sensitivity index (WBISI), homeostasis model of insulin resistance (HOMA(IR)) were compared among these three subgroups.

RESULT(1) Among all the obese children, the prevalence of NAFLD, SNAFL, NASH and MS was 65.9% (203), 45.5% (140), 20.5% (63) and 24.7% (76) respectively. Among all the MS children, the prevalence of NAFLD was 84.2% (64/76). The prevalence of MS was 29.3% (41/140) in SNAFL group and 36.5% (23/63) in NASH group, which was significantly higher than that of OCWLD group 11.4% (12/105) (P < 0.05), but no significant difference was found between SNAFL group and NASH group (P > 0.05). Moreover, there were significantly higher incidences in NASH group concerning every component of MS (hypertension, hyperlipidemia, hyperglycemia) compared with that of OCWLD group. The incidence of hypertension in SNAFL was significantly higher than that of OCWLD group. And the incidence of hyperlipidemia was markedly increased in NASH group compared with SNAFL group. NAFLD group had higher free insulin and more severe IR compared with that of OCWLD group. When OCWLD developed to SNAFL and NASH, free insulin and IR deteriorated calculated by HOMA-IR and WBISI. However there was no significant difference between NAFLD and MS children concerning free insulin and IR.

CONCLUSIONThe prevalence of NAFLD and MS hits high in obese children. The prevalence of NAFLD was very high among children with MS and NAFLD and MS shared the common mechanism of IR. The higher prevalence of MS and higher frequencies of MS components were tightly associated with the development of NAFLD and severity of IR.

Adolescent ; Child ; Fatty Liver ; diagnosis ; epidemiology ; etiology ; metabolism ; Female ; Humans ; Male ; Metabolic Syndrome ; diagnosis ; epidemiology ; Obesity ; complications ; epidemiology ; Prevalence

BACKGROUND: The purpose of this study is to analyze the effects of an abdominal obesity management program in middle-aged women in Korea. METHODS: Examination of databases, including the Research Information Sharing Service, Database Periodical Information Academic, and Korean Studies Information, resulted in identification of 772 studies performed up to 2014, of which 43 satisfied the inclusion data. Data analysis was performed using R version 3.2 to calculate the effect sizes, explore possible causes of heterogeneity, and check for publication bias, using a funnel plot and its trim-and-fill analysis. RESULTS: The mean effect size of the management program was small (g=0.22), along with the anthropometric index (g=0.18), metabolism index (g=0.21), fat-distribution (g=0.36), and inflammatory index (g=0.36). Moderator analysis was performed to determine heterogeneity, but no significant differences were found between the randomized controlled trial (RCT) group and non-RCT group. In addition, the length of the session was found to be statistically significant after performing a meta-regression. Finally, a funnel plot with a trim-and-fill analysis was produced to check for publication bias, but no significant bias was detected. CONCLUSION: Based on these findings, the abdominal obesity management program affects middle-aged women in Korea. Further research is needed to target other age groups with abdominal obesity.
Bias (Epidemiology) ; Female ; Humans ; Information Dissemination ; Korea ; Metabolism ; Obesity, Abdominal ; Population Characteristics ; Publication Bias ; Statistics as Topic

OBJECTIVETo compare the prevalence rates of metabolic syndrome (MS) in obese children, according to three commonly used 'Pediatric MS definitions': (1) the International Diabetes Federation (IDF), (2) Cook, et al, and(3)da Silva, et al, in order to choose an appropriate one for the Chinese obese children. It was also intended to assess the variances of American or Chinese cutoff values on MS prevalence.

METHODSA retrospective study was performed in obese children from Obesity Outpatient Service Program from January 2004 to December 2008. Subjects were eligible if they met the following criteria: (1) aged 7 to 18 years, (2) with no following conditions as hereditary endocrine or metabolic diseases, secondary obesity, hepatic or renal disease, using medication that alters blood pressure or glucose or lipid metabolism etc., (3) data were complete on the variables of interest. Height, weight and waist circumference, systolic and diastolic blood pressure, fasting lipid profiles, blood sugar and insulin were measured. Insulin resistance was evaluated by homeostasis model assessment (HOMA). American or Chinese cutoff values were used to identify central obesity and hypertension. The prevalence rates of MS under three definitions were calculated and compared by Kappa test to determine the degree of agreement.

RESULTS136 patients with 103 males and 33 females were enrolled in the study. According to the American cutoff value, 19.2%, 34.6%, 52.9% of the subjects were classified as MS under definitions of IDF, Cook, et al, da Silva, et al respectively, matching well with 19.2%, 43.4%, 58.1% when the Chinese cutoff value was used (Kappa = 1, 0.79, 0.90). The degrees of agreement according to the Kappa statistics between Cook, et al and da Silva, et al (0.52, American cutoff value/0.51, Chinese cutoff value) were better than the others (0.24 - 0.4). Children who were diagnosed as MS under the definitions of Cook, et al. or da Silva, et al. appeared to have had serious insulin resistance when compared to those without MS.

CONCLUSIONPrevalence of the metabolic syndrome appeared to be high among the obese pediatric outpatients, which was probably due to the definition being chosen. The use of definitions provided by Cook, et al and da Silva, et al might be more suitable for MS diagnosis in obese children in the outpatient department, if insulin resistance was under consideration. Both American and Chinese cutoff value could be used for MS diagnosis in the Chinese obese children.

Adolescent ; Child ; Female ; Humans ; Insulin ; metabolism ; Insulin Resistance ; Male ; Metabolic Syndrome ; epidemiology ; metabolism ; Obesity ; epidemiology ; metabolism ; Prevalence ; Retrospective Studies ; Risk Factors

OBJECTIVETo determine the prevalence of nonalcoholic fatty liver disease (NAFLD) and metabolic abnormalities in obese children and adolescents in Beijing.

METHODSThis study involved 387 obese children and adolescents, aged 12 to 17 years in Beijing. Data on anthropometric measurements was collected, including weight, height and age. All subjects underwent a clinic examination containing fasting blood and liver ultrasonography. Nonalcoholic fatty liver disease was diagnosed using diagnostic criteria for nonalcoholic fatty liver disease which was recommended by the Fatty liver and Alcoholic Liver Disease Study Group of Liver Disease Association in China.

RESULTS174 out of the 387 children were diagnosed as having NAFLD. The overall prevalence of NAFLD was 45.0% in this study population. The prevalence rates of NAFLD did not show significant difference between girls and boys. The prevalence rates of diabetes mellitus and IFG were 0.8% and 49.1% respectively. The prevalence rates of HTG, HTC, HLDL-C, LHDL-C, IFG, elevated ALT (or AST) and acanthosis nigricans were 6.3%, 4.0%, 37.9%, 22.8%, 46.0%, 17.8% and 28.5% in students combined with obesity and NAFLD, respectively. In the NAFLD subgroup, higher prevalence of high TG, acanthosis nigricans, abnormal ALT or AST were seen. With the increasing of obesity, the level of LDL-C, TG, liver function disturbance and prevalence of NAFLD and acanthosis nigricans were aggravated. Under binary logistic regression analysis, results showed that high BMI, acanthosis nigricans and TG were significantly correlated with NAFLD in obese children and adolescent population.

CONCLUSIONNAFLD was common in obese children, and the prevalence of NAFLD in obese children was 45.0%. Higher BMI, acanthosis nigricans and abnormal TG were independent risk factors for NAFLD in obese children. Obese children who had been exposed to high risk factors should take the ultrasonography.

Adolescent ; Body Mass Index ; Child ; China ; epidemiology ; Female ; Humans ; Insulin Resistance ; Logistic Models ; Male ; Non-alcoholic Fatty Liver Disease ; epidemiology ; Obesity ; epidemiology ; metabolism ; Prevalence ; Risk Factors ; Surveys and Questionnaires

OBJECTIVETo investigate the joint effect of birth weight and each of obesity measures (body mass index (BMI) and waist circumference (WC)) on abnormal glucose metabolism (including diabetes) at adulthood.

METHODSUsing the historical cohort study design and the convenience sampling method, 1 921 infants who were born in Beijing Union Medical College Hospital from June 1948 to December 1954 were selected to do the follow-up in 1995 and 2001 respectively. Through Beijing Household Registration and Management System, they were invited to participate in this study. A total of 972 subjects (627 were followed up in 1995 and 345 were followed up in 2001) with complete information on genders, age, birth weight, family history of diabetes, BMI, WC, fasting plasma glucose (FPG) and 2-hour plasma glucose (2 h PG) met the study inclusion criteria at the follow-up visits. In the data analysis, they were divided into low, normal, and high birth weight, respectively. The ANOVA and Chi-squared tests were used to compare the differences in their characteristics by birth weight group. In addition, multiple binary Logistic regression model was used to investigate the single effect of birth weight, BMI, and waist circumference on abnormal glucose metabolism at adulthood. Stratification analysis was used to investigate the joint effect of birth weight and each of obesity measures (BMI and WC) on abnormal glucose metabolism.

RESULTSThere were 972 subjects (males: 50.7%, mean age: (46.0±2.2) years) included in the final data analysis. The 2 h PG in low birth weight group was (7.6±3.2) mmol/L , which was higher than that in normal birth weight group (6.9±2.1) mmol/L and high birth weight group (6.4±1.3) mmol/L (F=3.88, P=0.021). After adjustment for genders, age, body length, gestation age, family history of diabetes, physical activity, smoking and alcohol consumption, and duration of follow-up, subjects with overweight and obesity at adulthood had 2.73 (95% confidence interval (CI) =2.06- 3.62) times risk to develop abnormal glucose metabolism when compared with norm weight ones. Likewise, subjects with central obesity were more likely to develop abnormal glucose metabolism than ones with normal waist (odds ratio (OR)=3.35, 95%CI=2.49-4.50). In addition, compared to subjects with normal birth weight and normal BMI at adulthood, ones with normal birth weight and overweight (including obesity) at adulthood were more likely to have abnormal glucose metabolism (OR= 2.60, 95%CI=1.94-3.49); subjects with low birth weight and overweight (including obesity) at adulthood had the highest risk for abnormal glucose metabolism (OR=4.70, 95% CI=1.84- 11.99). The attributable proportion of interaction between low birth weight and overweight (including obesity) at adulthood was 48.5%. In addition, compared to subjects with normal birth weight and normal WC at adulthood, one with normal birth weight and central obesity at adulthood were more likely to have abnormal glucose metabolism (OR=3.18, 95% CI=2.33- 4.32); subjects with low birth weight and central obesity at adulthood had the highest risk for abnormal glucose metabolism (OR=4.78, 95% CI=2.01- 11.38); subjects with high birth weight and central at adulthood also had high risk for abnormal glucose metabolism (OR=4.35, 95%CI=1.38- 13.65). We found that the attributable proportion of interaction between low birth weight and central obesity at adulthood was 38.5% , and was 28.3% for interaction between high weight and central obesity.

CONCLUSIONThere was strong interaction effect between birth weight and overweight (especially central obesity) at adulthood on abnormal glucose metabolism at adulthood. Effective measures should be adopted to prevent and control adult obesity in order to offset the adverse effect of birth weight on long-term health risk.

Adult ; Birth Weight ; Blood Glucose ; analysis ; Body Height ; Body Mass Index ; Cohort Studies ; Female ; Glucose ; metabolism ; Humans ; Male ; Middle Aged ; Obesity ; epidemiology ; Obesity, Abdominal ; epidemiology ; Odds Ratio ; Overweight ; epidemiology ; Waist Circumference

Children born to mothers with gestational diabetes mellitus (GDM) are more likely to exhibit congenital malformations, high birth weight, and obesity and have an increased risk of developing type 2 diabetes in later life. Children who are exposed to maternal diabetes in utero may be 'programmed' for later development of obesity at a critical period of development. Therefore, the purpose of the present study was to examine the associations among adiposity and systolic blood pressure in children and abnormal maternal glucose levels during pregnancy. A total of 856 mother-child pairs were included in the present retrospective study. Eligible pregnant women underwent a standard 75 g oral glucose tolerance test between 24 and 28 weeks' gestation. Anthropometric characteristics of their children were measured at 6 years of age, including body mass index, the sum of subscapular and tricep skinfold thickness, and systolic blood pressure. The result suggests that children exposed to GDM have higher adiposity; prevention of childhood obesity needs to begin early in life for these children.
Adiposity ; physiology ; Aging ; Child ; China ; epidemiology ; Diabetes, Gestational ; metabolism ; Female ; Humans ; Obesity ; etiology ; Pregnancy ; Prenatal Exposure Delayed Effects ; Risk Factors

OBJECTIVETo explore the relationship between serum level of leptin and the components of metabolic syndrome in a group of mid-aged Chinese population.

METHODS345 adults (184 men and 161 women) aged 46 - 53 were enrolled from Fetal Origin of Adult Disease (FOAD) cohort to participate the clinic examination including anthropometry, measurements of blood pressure, fasting and 2 hr plasma levels of glucose and insulin, serum levels of lipid and leptin. HOMA-IR index was calculated to estimate individual insulin resistance. Metabolic syndrome (MS) was diagnosed according to the definition criteria issued by the International Diabetes Federation (IDF) in 2005.

RESULTSThe prevalences of central obesity, higher serum level of triglyceride (TG), lower serum level of high-density lipoprotein (HDL-C), IFG, higher blood pressure and MS were 53.0%, 47.5%, 34.2%, 26.7%, 33.9%, 31.9% in this mid-aged population, respectively. Serum geometric mean level of leptin was higher in females than in males. Serum level of leptin increased with the prevalence of MS and components of abnormal metabolism. The serum level of leptin compared with central obesity, higher blood pressure, higher serum level of triglyceride (TG), lower serum level of high-density lipoprotein cholesterol (HDL-C), IFG and MS was significantly higher respectively (P < 0.05) without HDL-C in males. The serum level of leptin increased with the number of components of abnormal metabolism subjects had (P < 0.001).

CONCLUSIONThe serum level of leptin in this population is significantly associated with MS and components of MS. Hyperleptinemia could be a new component of metabolic syndrome. It might be a target in selection of MS and relative diseases.

China ; epidemiology ; Cholesterol, HDL ; blood ; Cohort Studies ; Female ; Humans ; Hyperinsulinism ; blood ; Insulin ; metabolism ; Insulin Resistance ; Leptin ; blood ; Male ; Metabolic Syndrome ; blood ; epidemiology ; Middle Aged ; Obesity ; blood

OBJECTIVETo assess the obesity prevalence in Saudi adults according to the international standards of body mass index (BMI) and body fat percentage (BF%).

METHODSFive hundred and thirty healthy Saudi adults aged 18-72 years (mean 36.91 ± 15.22 years) were enrolled in this study. Their body composition was assessed by bioelectrical impendence analysis with a commercially available body composition analyzer. Standard BMI and BF% values were used to define obesity.

RESULTSThe prevalence of underweight, normal underweight, overweight and obesity in Saudi adults according to the BMI criteria (<18.5 kg/m², 18.5-24.4 kg/m², 25-29.9 kg/m², 30 kg/m² and above, respectively) was 2.5%, 30.2%, 33.6%, and 33.8%, respectively, whereas the obesity prevalence was 60% (n=318) in Saudi adults according to the BF% criteria (25% for males and 30% for females), which was significantly higher than that according to BMI criteria. However, it was 50.6% (n=268) when the BMI cutoff point was 27.5 kg/m², proposed by WHO for the Asian population. Kappa analysis showed that the obesity prevalence defined by BMI and BF% was higher in females than in males (k=0.530 vs k=0.418, P<0.0001). The sensitivity and specificity of BMI (30 kg/m² and 27.5 kg/m²) were 54.1% and 96.7% and 76.4% and 88.2%, respectively, for obesity. A lower BMI cutoff point (26.60 kg/m²) was proposed in this study, which gave the maximum sensitivity (84.3%) and specificity (85.4%), with a moderate kappa agreement (k=0.686). Moreover, the obesity prevalence at this cutoff point (56.4%) was significantly higher than that recommended by WHO.

CONCLUSIONThe specificity of BMI for obesity is high and its sensitivity is low in both sexes. Its sensitivity can be increased by changing BMI cutoff to a lower value. The choice of BF% reference is of great influence for the assessment of obesity prevalence according to the BMI.

Adipose Tissue ; metabolism ; Adolescent ; Adult ; Aged ; Body Mass Index ; Female ; Humans ; Male ; Middle Aged ; Obesity ; epidemiology ; Saudi Arabia ; epidemiology ; Young Adult