No abstract availble.
Adenoma/diagnosis/epidemiology/*etiology ; Anticipation, Genetic ; Colonic Neoplasms/diagnosis/epidemiology/*etiology ; Humans ; *Insulin Resistance ; Obesity/*complications/epidemiology ; Risk Factors

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

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease seen in patients with obesity, diabetes, and metabolic syndrome. Metabolic syndrome is an important predictor of the severe form of NAFLD, nonalcoholic steatohepatitis (NASH), and NASH patients with diabetes have an increased risk of liver cirrhosis and hepatocellular carcinoma. With the prevalence of obesity and diabetes around the world, NAFLD has become a global public health problem. NAFLD is not only one of the most important causes of liver-related disability and mortality, but also associated with the increasing incidence of diabetes and cardiovascular disease. The effective prevention and treatment of NAFLD is expected to reduce the burden of liver disease and cardiovascular disease. Therefore, this article overviews the advances in the diagnosis, prevention, and treatment of NAFLD.
Carcinoma, Hepatocellular ; epidemiology ; Cardiovascular Diseases ; epidemiology ; Diabetes Mellitus ; epidemiology ; Humans ; Liver Cirrhosis ; epidemiology ; Liver Neoplasms ; epidemiology ; Metabolic Syndrome ; epidemiology ; Non-alcoholic Fatty Liver Disease ; diagnosis ; epidemiology ; therapy ; Obesity ; epidemiology ; Prevalence

INTRODUCTIONThe incidence of childhood obesity is rising across the globe, and obesity related co-morbidities are increasing concomitantly in the paediatric population.

MATERIALS AND METHODSPubMed search for research and review papers on complications of childhood obesity was performed.

RESULTSThe consequences of childhood obesity can be broadly classified into medical and psychosocial consequences. Medical consequences include metabolic complications such as diabetes mellitus, hypertension, dyslipidaemia and non-alcoholic fatty liver disease, and mechanical problems such as obstructive sleep apnoea syndrome and orthopaedic disorders. Psychological and social consequences are prevalent but often overlooked. Local data on these complications were also discussed.

CONCLUSIONChildhood obesity is associated with significant morbidities, which not only have immediate impact on the health of the obese children, but also significantly increase the risk of morbidities in adulthood.

Adolescent ; Body Mass Index ; Child ; Comorbidity ; Humans ; Obesity ; complications ; diagnosis ; epidemiology ; Young Adult

OBJECTIVETo study the effectiveness of waist circumference cut-off values in predicting the prevalence of metabolic syndrome (MetS) and risk factors in adults in China.

METHODSA cross-sectional survey was condcuted in 14 provinces (autonomous region, municipality) in China. A total of 47,325 adults aged⋝20 years were selected by multistage stratified sampling, and questionnaire survey and physical and clinical examination were conducted among them. MetS was defined according to the International Diabetes Federation (IDF) criteria and modified IDF criteria.

RESULTSThe age-standardized prevalence of MetS was 24.2% (22.1% in men and 25.8% in women) and 19.5% (22.1% in men and 18.0% in women) according to the IDF criteria and modified IDF criteria respectively. The age-standardized prevalence of pre-MetS was 8.1% (8.6% in men and 7.8% in women) according to the modified IDF criteria. The prevalence of MetS was higher in urban residents than rural residents and in northern China residents than in southern China residents. The prevalence of central obesity was about 30% in both men and women according to the ethnicity-specific cut-off values of waist circumference for central obesity (90 cm for men and 85 cm for women). Multivariate regression analysis revealed no significant difference in risk factors between the two MetS definitions.

CONCLUSIONUsing both the modified IDF criteria and ethnicity-specific cut-off values of waist circumference can provide more useful information about the prevalence of MetS in China. Conclusion Using both the modified IDF criteria and ethnicity-specific cut-off values of waist circumference can provide more useful information about the prevalence of MetS in China.

Adult ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Metabolic Syndrome ; diagnosis ; epidemiology ; Middle Aged ; Obesity ; epidemiology ; Prevalence ; Risk Assessment ; Risk Factors ; Waist Circumference

This study compared the prevalence of metabolic syndrome (MetS), its risk factors, and obesity in adolescents in the United States (US) and Korea. Data were obtained from 2003-2004 US National Health and Nutrition Examination Survey (NHANES) and 2005 Korea NHANES for adolescents aged 12-19 yr in the US (n=734) and in Korea (n=664). The 2007 International Diabetes Federation (IDF) pediatric definition for diagnosis of MetS and the 2000 US Growth Charts and 2007 Korea Growth Charts for assessment of obesity were utilized. The prevalence of metabolic syndrome in US and Koreans was 5.5% and 2.5%, respectively. The prevalence of obesity was 18.1% in US compared to 9.0% in Koreans. The prevalence of abdominal obesity, hyperglycemia, and hypertriglyceridemia were higher in the US, whereas that of low HDL-C levels was higher in Korea. Despite the doubled prevalence for the single entities of MetS and obesity in the US, the prevalence of MetS in obese US and Koreans did not differ (20.8% and 24.3%, respectively). In conclusion, there are differences in the prevalence of MetS, obesity, and the individual MetS risk factors between the US and Korean adolescents; however, the risk of MetS among obese adolescents is similar in both countries.
Adolescent ; Female ; Humans ; Male ; Metabolic Syndrome X/diagnosis/*epidemiology ; Obesity/diagnosis/*epidemiology ; Prevalence ; Republic of Korea ; Risk Factors ; United States ; Young Adult

OBJECTIVECentral obesity is considered to be a central component of metabolic syndrome. Waist circumference (WC) has been widely used as a simple indicator of central obesity. This study is aimed to evaluate the sensitivity of WC cut-off values for predicting metabolic risk factors in middle-aged Chinese.

METHODSThe study involved 923 subjects aged 40-65 years. The metabolic risk factors were defined according to the Chinese Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. WC cut-off 85-90 cm and ⋝90 cm were used as cut-off values of central pre-obesity and central obesity in males, respectively, while WC 80-85 cm and ⋝85 cm were used as cut-off values of central pre-obesity and central obesity in females.

RESULTSFirst, WC values corresponding to body mass index (BMI) 24 kg/m2 and visceral fat area (VFA) 80 cm2 were 88.55 cm and 88.51 cm in males, and 81.46 cm and 82.51 cm in females respectively. Second, receiver operating characteristic curves showed that the optimal WC cut-off of value was 88.75 cm in males, higher than that in females (81.75 cm). Third, the subjects with higher WC values were more likely to have accumulating metabolic risk factors. The prevalence of metabolic risk factors increased linearly and significantly in relation to WC levels.

CONCLUSIONWC cut-off values of central pre-/central obesity are optimal to predict multiple metabolic risk factors.

Aged ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Intra-Abdominal Fat ; physiopathology ; Male ; Metabolic Syndrome ; diagnosis ; epidemiology ; physiopathology ; Middle Aged ; Obesity ; diagnosis ; ROC Curve ; Waist Circumference

BACKGROUND: Waist circumferences are widely used to diagnosis and assessment of obesity but various standards of the measuring waist circumference originate the confusion on diagnosis and assessment of obesity. According to this, this study is willing to light up standards of measuring waist circumference what is intimate with body mass index(BMI) and have a precision of intra observer and inter observers in repeated measurements of the waist. METHODS: Measuring of waist circumference by the 4 different standards(anterior superior iliac crest(ASIC), umbilicus, above 3 cm to ASIC, the thinnest area in the waist by the range of seeing) were performed on 102 people visiting Health Promotion Center of one medical collage hospital by two observers in each 2 times, total 16 times. Each data were analyzed by the relativity between the BMI and the each means of measuring waist circumference and by ANOVA test in intra observer and inter observer bias. RESULTS: The relation between BMI and data in measuring standard of ASIC of the waist circumference is the highest. (r=0.900) and the following umbilicus(r=0.896), above 3 cm to the anterior superior iliac crest(r=0.888), the thinnest area in the waist by the range of seeing(r=0.877), It is the lowest in intra observer bias that the thinnest area in the waist by the range of seeing, and ASIC in inter observer. CONCLUSION: It is desirable that ASIC is the standard of measuring waist circumference in the diagnosis of obesity and in measuring that by different two person, because of the highest relativity in BMI and the lowest inter observers bias. But the thinnest area in the waist by the range of seeing is desirable in measuring by same person because of intra observer bias.
Anthropometry ; Bias (Epidemiology) ; Body Constitution ; Body Mass Index ; Diagnosis ; Health Promotion ; Humans ; Obesity ; Observer Variation ; Umbilicus ; Waist Circumference*

The purpose of this study was to evaluate the associations between weight status and mental disorders, including depressive disorder, anxiety disorder and alcohol use disorder. A total of nationally representative 6,510 subjects aged 18-64 yr was interviewed in face-to-face household survey. Response rate was 81.7%. Mental disorders were diagnosed using the Korean version of the Composite International Diagnostic Interview (K-CIDI). The subjects reported their heights and weights. After adjusting for age and gender, the lifetime diagnosis of depressive disorder had a significant association with only the underweight group (odds ratio [OR], 1.68, 95% confidence interval [CI], 1.19-2.38). The association between underweight and depressive disorder was the strongest for subjects with a high education level (OR, 1.75, 95% CI, 1.2-2.56), subjects with a married/cohabiting status (OR, 1.94, 95% CI, 1.17-3.22) and smokers (OR, 2.58, 95% CI, 1.33-4.98). There was no significant association between obesity and depressive disorder in Korea. But there was a significant association between the underweight group and depressive disorder. The relationship between obesity and mental disorder in a Korean population was different from that in a Western population. These results suggest that the differences of traditional cultures and races might have an important effect on the associations between the weight status and mental disorders.
Adolescent ; Adult ; Alcohol-Related Disorders/diagnosis ; Anxiety Disorders/diagnosis ; *Body Weight ; Depressive Disorder/diagnosis ; Female ; Humans ; Interviews as Topic ; Male ; Mental Disorders/diagnosis/*epidemiology ; Middle Aged ; Obesity/diagnosis/epidemiology ; Odds Ratio ; Republic of Korea ; Risk Factors ; Thinness

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