BACKGROUND/AIMS: Overt thyroid dysfunction is well known to affect weight. However, the influence of normal-range changes in thyroid status on body mass index (BMI) is unclear. We sought to evaluate thyroid function (free T4, TSH) and its possible relationship with BMI and lipid profiles in euthyroid subjects. METHODS: A total of 1572 euthyroid women (mean age 46.2 years) who visited Daegu Catholic University Medical Centre for primary health screening participated in this cross-sectional study. Women who were not euthyroid and women who took thyroid medication were excluded. TSH, free T4, and lipid profile [total-cholesterol, triglyceride (TG), HDL-C, LDL-C] were evaluated. RESULTS: Obese euthyroid women had lower free T4 levels than did lean euthyroid women. After adjustment for age and smoking, free T4, but not TSH, was significantly negatively correlated with BMI. After adjustment for age, smoking, and BMI, free T4 was negatively correlated with TG to a significant degree. CONCLUSIONS: We demonstrated a negative correlation between free T4 within the normal range and BMI in euthyroid subjects. These findings suggest that low free T4 is associated with obesity in euthyroid subjects.
Adult ; *Body Mass Index ; Cholesterol/blood ; Cross-Sectional Studies ; Female ; Humans ; Korea/epidemiology ; Middle Aged ; Obesity/blood/epidemiology/*physiopathology ; Pilot Projects ; Thyroid Function Tests ; Thyroid Gland/*metabolism/physiopathology ; Thyrotropin/*blood ; Thyroxine/*blood ; Triglycerides/analysis/blood ; Triiodothyronine/blood

OBJECTIVETo explore the potential role of neuropeptide Y (NPY) in the pathophysiological process of hypertension caused by obstructive sleep apnea syndrome (OSAS).

METHODSThe concentration of serum NPY were measured with radioimmunoassay (RIA) in 417 subjects (97 normotensive controls without OSAS, 113 cases of normotensive with OSAS, 73 cases of hypertensive without OSAS and 134 cases of hypertensive with OSAS. Further, the mean NPY level were compared in four groups and the possible effective factors on NPY were discussed.

RESULTS(1) The concentration of NPY in four groups were (50.5 +/- 37.2) pmol/L in normal controls, (76.0 +/- 39.9) pmol/L in normotensive with OSAS group, (66.9 +/- 36.2) pmol/L in hypertensive without OSAS group and (86.8 +/- 36.8) pmol/L in hypertensive with OSAS group. Whether the patients with OSAS combined with hypertension or not, the concentration of NPY in the serum raised remarkably compared with those without OSAS and hypertension, the highest level of serum NPY was detected in OSAS combined with hypertension group. (2) Pearson correlation analysis indicated that both SBP and DBP related to the serum NPY significantly in non-OSAS group (AHI <10), while the BMI, abdominal circumference, AHI as well as the lowest level of SaO2 correlated to NPY besides SBP in OSAS group with (AHI > or =10). (3) Multiple linear regression model showed that the abdominal circumference and AHI were contributing factors to SBP, while neck circumference and BMI were contributing factors to DBP. The level of NPY in the serum were significantly affected by AHI and BMI, in which the former one had greater influence.

CONCLUSIONThe increased level of serum NPY may play weakly potential roles in the pathophysiological process of hypertension caused by OSAS.

Adult ; Blood Pressure ; Case-Control Studies ; Female ; Humans ; Hypertension ; blood ; epidemiology ; Male ; Middle Aged ; Neuropeptide Y ; blood ; Obesity ; Sleep Apnea, Obstructive ; blood ; complications ; physiopathology

PURPOSETo establish and propose a national body mass index (BMI) reference for screening overweight and obesity in Chinese school-age children and adolescents.

METHODS2000 CNSSCH (Chinese National Survey on Students Constitution and Health) data, including 216 620 primary and secondary school students aged 7 to 18 years old, were used as a reference population. Compared with those of the NCHS international reference, three temporary sets of cut-off BMI were proposed by testing different combinations of P85, P90, and P95. When physiological and biochemical measures between and among "obesity", "overweight", and "normal weight" groups were taken into consideration, set II was selected to be the most appropriate one. The sex-age-specific curves were then plotted and smoothed by using B-spline method.

RESULTSBased on the samples from costal developed metropolis, the BMI curves successfully overcame the shortcomings of lower and level-off tendency of the Chinese total population. Temporary set II, composed by cut-offs of P85 for overweight and P95 for obesity, was finally selected by its sensitivity and peculiarity. BMI 24 and 28 were used as cut-offs for overweight and obesity for both males and females aged 18 years old. These cut-offs, consistent with Chinese Adult's Reference, was proposed as the Body mass index reference for screening overweight and obesity in Chinese school-age children and adolescents.

CONCLUSIONThe new reference clearly showed its superiorty in both prospectivity and actuality. The proposed reference minimized the gaps of the BMI curve between Chinese adolescents and the international reference. Most importantly was that it was consistent with the Eastern Asia ethnic characteristics of body fatness growth. It was therefore proposed by the Working Group on Obesity in China (WGOC) to use it as an nationwide reference for screening overweight and obesity of school-age children and adolescents in China.

Adolescent ; Age Distribution ; Blood Pressure ; physiology ; Body Mass Index ; Body Weight ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Mass Screening ; Obesity ; diagnosis ; epidemiology ; physiopathology ; Overweight ; Reference Values ; Sex Characteristics

OBJECTIVETo study blood pressure levels, the prevalence of hypertension and factors associated with the development of hypertension in Hasakh children in the Yili region of Xinjiang Province.

METHODSA total of 2438 Hasakh school children from the Yili region of Xinjiang Province were sampled by stratified random cluster sampling method between May and June 2009. Height, weight, waist circumference, hip circumference, skinfold thickness and blood pressure were measured. Body mass index (BMI) was calculated.

RESULTSMean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 94±13 mm Hg and 60±9 mm Hg respectively in the 2438 children, and both averages were lower than in the Han children. Hypertension was noted in 138 children (5.66%). The prevalence of hypertension in girls (6.97%, 84/1206) was higher than in boys (4.38%, 54/1232) (P<0.05). The prevalence of hypertension and blood pressone were positively correlated with BMI, waist circumference, hip circumference, skinfold thickness circumference, gender and age.

CONCLUSIONSAverage blood pressure levels in Hasakh children in the Yili region of Xinjiang Province are lower than in domestic age-matched Han children. The prevalence of hypertension in girls is higher than in boys. Obesity is highly correlated with the development of hypertension.

Adolescent ; Blood Pressure ; Body Mass Index ; Child ; China ; epidemiology ; ethnology ; Female ; Humans ; Hypertension ; epidemiology ; etiology ; Male ; Obesity ; physiopathology ; Prevalence ; Risk Factors ; Skinfold Thickness ; Waist Circumference

OBJECTIVETo determine the prevalence and clinical phenotype of metabolic syndrome among overweight and obese schoolchildren in Beijing, and to compare the rates of diagnosis made according to the criteria of the National Cholesterol Education Program (NCEP) of the United States and International Diabetes Federation (IDF).

METHODSBased on Beijing Child and Adolescent Metabolic Syndrome (BCAMS) study with body mass index (BMI), waist circumference (WC) and blood pressure measured, the overweight and obese children were screened among nearly 20 000 children 6-18 years of age in Beijing by Chinese BMI cutoffs for schoolchildren (7-18 years) and the US 2000 CDC Growth Charts--the 85th and 95th percentile (6 years) and were enrolled as the study population. Simultaneously a group of children with normal BMI were selected as the control group and based on the international method of age grouping, each of the above groups was divided further into 4 sub-groups in terms of age: 6-9, 10-12, 13-15 and 16-18 years old, respectively. Fasting plasma glucose (FPG) and insulin (FINS), serum high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were examined. HOMA-IR index was calculated for estimating individual insulin resistance. A child who met any three or more of the following five criteria, according to NCEP definition, was diagnosed as MS. A diagnosis of MS using IDF definition required abdominal obesity plus any two or more of the other four criteria: (1) abnormal obesity: WC > or = P(90); (2) elevated BPs: SBP/DBP > or = P(90); (3) low HDL-C: HDL-C < 1.03 mmol/L (40 mg/dl); (4) high TG: TG > or = 1.24 mmol/L (110 mg/dl); (5) impaired fasting glucose (IFG): FPG > or = 5.6 mmol/L (100 mg/dl).

RESULTSThe prevalence rates of MS by NCEP definition were: 0.9%, 7.6% and 29.8% in the normal weight (control group), overweight and obese children, respectively, which were higher than the rates diagnosed by IDF definition with 0.1%, 5.2% and 28.6% in the three groups. The prevalence rates of individual MS component among obese children were: 81.6% for abnormal obesity, 47.7% for elevated BPs, 35.6% for high TG, 16.9% for low HDL-C, and 13.4% for IFG. Elevated BPs (29.8%), abnormal obesity (27.4%) and high TG (26.0%) were the leading three abnormalities among overweight children. With the increase of BMI, the clustering of MS components and insulin resistance (HOMA-IR) were remarkably increased. HOMA-IR significantly increased as the number of MS component increased.

CONCLUSIONSMS has been in an epidemic status among the obese schoolchildren in Beijing. Abnormal obesity, elevated BPs and high TG were the three most common metabolic abnormalities for overweight and obese children. The prevalence rates of MS by NCEP definition in the present study was higher than those diagnosed by using IDF definition.

Adolescent ; Blood Glucose ; analysis ; Body Mass Index ; Body Weight ; Child ; China ; epidemiology ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Diabetes Mellitus, Type 2 ; metabolism ; Growth Charts ; Humans ; Insulin ; analysis ; Insulin Resistance ; genetics ; physiology ; Male ; Metabolic Syndrome ; physiopathology ; Obesity ; epidemiology ; metabolism ; physiopathology ; Obesity, Abdominal ; pathology ; Overweight ; epidemiology ; etiology ; metabolism ; Prevalence ; Triglycerides ; analysis ; Waist Circumference

OBJECTIVETo explore the clustering character of overweight and obesity with multiple cardiovascular disease risk factors such as blood pressure, serum lipids and glucose, and to provide evidence for intervention in childhood.

METHODSA cross-sectional study was conducted on 913 children aged 7-13 years in urban area of Shijiazhuang. Measurements included height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP) and fasting serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and serum glucose (GLU).

RESULTSOverall prevalence rate of overweight and obesity was 29.24% (boys: 34.98% vs. girls: 24.23%). When compared with normal children, children with overweight or obesity had significantly higher levels of SBP, DBP, TC, TG but low HDL-C. The prevalence rates of high SBP, DBP, TC, TG, GLU and low HDL-C in overweight and obese children were higher than in normal children. After adjusted for gender and age, the odds ratios of overweight and obese children for high SBP, DBP, TC, TG, GLU and low HDL-C were 6.77, 3.22, 2.55, 6.42, 3.85 and 2.94 (95% CI: 4.15-11.04, 1.38-7.49, 1.59-4.11, 3.46-11.92, 1.69-8.78 and 1.83-4.73), respectively. Odds ratios of overweight and obese children holding any one, two or three of the selected six risk factors appeared to be 2.74, 13.15 and 15.33 (95% CI : 1.92-3.92, 6.69-25.87 and 4.17-56.39), respectively.

CONCLUSIONChildhood overweight and obesity increased the clustering of children's risk factors on cardiovascular diseases, as well as increasing the risk of children acquiring multiple cardiovascular disease risk factors. Controlling overweight and obesity would help early prevention on children from getting cardiovascular diseases.

Adolescent ; Blood Glucose ; metabolism ; Blood Pressure ; Cardiovascular Diseases ; prevention & control ; Child ; China ; epidemiology ; Cities ; statistics & numerical data ; Cluster Analysis ; Female ; Humans ; Lipids ; blood ; Male ; Obesity ; blood ; epidemiology ; physiopathology ; Risk Factors ; Schools ; statistics & numerical data

BACKGROUND: Several reports have documented that Asians have a strong tendency to develop insulin resistance. The aims of this study were to evaluate the relative effects of insulin resistance and obesity on the risk factors for coronary heart disease (CHD) and to clarify whether insulin resistance accentuates these effects in apparently healthy men. METHODS: We conducted a cross sectional survey on 4, 067 apparently healthy Korean men, aged between 20 and 83 years, with body mass indices (BMI) ranging from 15.19 to 40.29 kg/m2. The presence of insulin resistance was defined as a homeostasis model assessment (HOMA-IR) value > 2.23, which is the cutoff for the highest decile in the normal BMI group (BMI < 23 kg/m2; 1, 438 subjects). RESULTS: The prevalence of insulin resistance was 24.7% in the overweight subjects (23< or=BMI< 25 kg/m2; 1, 259 subjects) and 43.9% in the obese subjects (BMI> or=25 kg/m2; 1, 370 subjects). The BMI was identified as the major determinant for total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), and waist circumference (WC) as the most important for apolipoprotein B (Apo B), systolic and diastolic blood pressures and C-reactive protein (CRP), and HOMA-IR as the most important for fasting blood sugar, triglyceride (TG), low high-density lipoprotein cholesterol (HDL-C), apolipoprotein A-I (Apo A-I) and TC/HDL ratio. The presence of insulin resistance was found to accentuate the risk factors for CHD, with the exception of LDL-C and Apo A-I in the obese. CONCLUSION: WC and HOMA-IR were found to be closely associated with non-traditional markers for CHD, such as high Apo B, hypertriglyceridaemia and the TC/HDL-C ratio, which are predictors for the presence of small, dense LDL particles. The insulin resistance among obese men was more prevalent than expected, and the presence of insulin resistance accentuates the effect of obesity in terms of the risk of CHD.
Adult ; Aged ; Aged, 80 and over ; Apolipoprotein A-I/blood ; Blood Glucose/metabolism ; Blood Pressure ; Body Mass Index ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Coronary Disease/epidemiology/*physiopathology ; Cross-Sectional Studies ; Humans ; *Insulin Resistance ; Korea/epidemiology ; Male ; Middle Aged ; Obesity/epidemiology/*physiopathology ; Predictive Value of Tests ; Risk Factors

PURPOSE: The purpose of this study was to compare metabolic syndrome (MS) risk factor prevalence by obesity and age in middle-aged women. METHOD: Two hundred and fifty-one subjects were recruited from the health promotion center of a tertiary care hospital in an urban city. MS was defined by the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults(Adult Treatment Panel III)(ATPIII), and obesity was determined by body mass index(BMI)> or = 25kg/m2. RESULTS: The mean blood pressure, fasting glucose, total cholesterol, and triglyceride were significantly higher in the obese group than in the non-obese group. The prevalence of MS, hypertension, and impaired fasting glucose were significantly higher in the obese group than in the non-obese group. In the forties, blood pressure was significantly higher in the obese group than in the non-obese group. In the fifties, body fat, systolic blood pressure, fasting glucose, total cholesterol, and triglyceride were significantly higher in the obese group than in the non-obese group. CONCLUSIONS: These results show that the nurse should focus on the obese fifty year old female patients for improvement of the MS risk factors.
Women's Health ; Adult ; Blood Pressure ; Body Fat Distribution ; Body Mass Index ; Cholesterol/blood ; Female ; Health Surveys ; Humans ; Metabolic Syndrome X/*epidemiology/etiology ; Middle Aged ; Models, Nursing ; Obesity/*complications/epidemiology/physiopathology ; Prevalence ; Risk Factors

OBJECTIVES: The aim of this study is to investigate the association between obesity indices (body mass index, weight, waist-hip ratio and waist circumference) in adolescents and the carotid intima-media thickness (C-IMT) in early adulthood. We also wanted to identify the best predictor for C-IMT among these obesity indices. METHODS: This study used community-based prospective cohort study, known as the Kangwha Study, and the data we used were from subjects who were 16-years old in 1996 (defined as "adolescencec") and 25 years-old in 2005 (defined as "early adulthoodc"). The 256 subjects (113 men and 143 women) who were used for analysis participated in both follow-ups, and they underwent B-mode ultrasonography of the carotid arteries at the early adulthood follow-up. Obesity indices were defined as the body mass index, weight, waist-hip ratio and waist circumference. The C-IMT was defined as the mean of the maximal IMT of each common carotid artery. The C-IMT and obesity indices associations were evaluated via multivariable regression, logistic regression and the receiver-operator characteristic curve analyses. RESULTS: In men, all the obesity indices in adolescence were showed to have statistically significant positive association with C-IMT in early adulthood. However, no such relationship was showed in women. On multiple regression and logistic regression analysis, the waist-hip ratio showed the biggest relationship with the C-IMT among the 4 obesity indices. However, there were no statistical significant differences and no best predictor was found. For the women, the obesity incidences and C-IMT showed no relationships. CONCLUSIONS: This study suggested that obesity in adolescence was related to an increase C-IMT in healthy young Korean men.
Adolescent ; Adult ; Blood Glucose/analysis ; Blood Pressure ; Carotid Arteries/*pathology ; Female ; Humans ; Korea/epidemiology ; Lipids/blood ; Male ; Obesity/*pathology/physiopathology ; Prospective Studies ; Sex Factors ; Tunica Intima/*pathology ; Waist-Hip Ratio

INTRODUCTION: Pregnant women are reported to be at increased risk of severe coronavirus disease 2019 (COVID-19) due to underlying immunosuppression during pregnancy. However, the clinical course of COVID-19 in pregnancy and risk of vertical and horizontal transmission remain relatively unknown. We aim to describe and evaluate outcomes in pregnant women with COVID-19 in Singapore. METHODS: Prospective observational study of 16 pregnant patients admitted for COVID-19 to 4 tertiary hospitals in Singapore. Outcomes included severe disease, pregnancy loss, and vertical and horizontal transmission. RESULTS: Of the 16 patients, 37.5%, 43.8% and 18.7% were infected in the first, second and third trimesters, respectively. Two gravidas aged ≥35 years (12.5%) developed severe pneumonia; one patient (body mass index 32.9kg/m2) required transfer to intensive care. The median duration of acute infection was 19 days; one patient remained reverse transcription polymerase chain reaction (RT-PCR) positive >11 weeks from diagnosis. There were no maternal mortalities. Five pregnancies produced term live-births while 2 spontaneous miscarriages occurred at 11 and 23 weeks. RT-PCR of breast milk and maternal and neonatal samples taken at birth were negative; placenta and cord histology showed non-specific inflammation; and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific immunoglobulins were elevated in paired maternal and umbilical cord blood (n=5). CONCLUSION The majority of COVID-19 infected pregnant women had mild disease and only 2 women with risk factors (obesity, older age) had severe infection; this represents a slightly higher incidence than observed in age-matched non-pregnant women. Among the women who delivered, there was no definitive evidence of mother-to-child transmission via breast milk or placenta.
Abortion, Spontaneous/epidemiology* ; Adult ; COVID-19/transmission* ; COVID-19 Nucleic Acid Testing ; COVID-19 Serological Testing ; Cohort Studies ; Disease Transmission, Infectious/statistics & numerical data* ; Female ; Fetal Blood/immunology* ; Humans ; Infectious Disease Transmission, Vertical/statistics & numerical data* ; Live Birth/epidemiology* ; Maternal Age ; Milk, Human/virology* ; Obesity, Maternal/epidemiology* ; Placenta/pathology* ; Pregnancy ; Pregnancy Complications, Infectious/physiopathology* ; Pregnancy Outcome/epidemiology* ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Prospective Studies ; RNA, Viral/analysis* ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; Singapore/epidemiology* ; Umbilical Cord/pathology* ; Young Adult