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Biomedical subjects

T S Han

Publications and source records attributed to T S Han.

At least 19 recordsLinked to original sources
PubMed2006

Association of glomerular podocytopathy and nephrotic proteinuria in mesangial lupus nephritis.

We investigated a series of patients with systemic lupus erythematosus (SLE), who had sparse subepithelial and mesangial immune deposits. Our goal was to determine structure: function correlation. We examined whether proteinuria correlated with either capillary wall immune aggregate formation or abnormal podocyte morphology. Renal biopsies from patients with sparse (two or fewer subepithelial or intramembranous electron dense deposits per glomerular capillary loop) immune deposits and podocyte effacement were studied. Patients fulfilled criteria for the diagnosis of SLE. Cases were excluded if the biopsy showed endocapillary proliferation or necrosis. Eighteen biopsies were studied, five from patients with nephrotic range proteinuria (> or =3 g/day) and 13 from patients with non-nephrotic proteinuria (<3 g/day). The five nephrotic patients had a mean foot process effacement of 48% +/- 39% (range 10-100%). Thirteen non-nephrotic patients had a mean foot process effacement of 11.7% +/- 8% (range 0-20%). The only distinguishing morphologic finding associated with nephrotic range proteinuria was diffuse foot process effacement. No correlation between subepithelial deposits and proteinuria was observed. There were no other histologic differences between the nephrotic and non-nephrotic patients. Among these patients, the nephrotic syndrome appears best correlated with podocytopathy rather than subepithelial electron dense deposits, mesangial deposits, or mesangial hypercellularity.

Adult↗
PubMed2005

Clothing size as an indicator of adiposity, ischaemic heart disease and cardiovascular risks.

OBJECTIVE: To relate subjects' clothing sizes to waist circumference, body mass index (BMI) and to the risks of ischaemic heart disease, hypertension and diabetes mellitus, and to derive cut-off levels of clothing size that correspond to increased health risks. DESIGN: Cross-sectional study. Setting Glasgow Royal Infirmary. PARTICIPANTS: A stratified subsample of 201 men and 161 women aged 27-67 years from the Glasgow monitoring coronary (MONICA) risk factor survey. MAIN OUTCOME MEASURES: Measured waist, weight and height, blood pressure and history of ischaemic heart disease (angina, myocardial infarction or angioplasty), hypertension and diabetes mellitus, and medications. RESULTS: There were 15.5% of men and 11.2% of women with ischaemic heart disease, 14.9% of men and 12.4% of women with hypertension, and 4.5% of men and 3.1% of women with diabetes mellitus. Age and smoking adjusted prevalences of these cardiovascular risks, as well as increased adiposity (waist circumference > or =102 cm in men, > or =88 cm in women or BMI > or = 30 kg m(-2)) rose with increasing clothing size. Clothing size correlated (P < 0.001) linearly with indices of adiposity. Clothing sizes which correspond to waist circumference action level 1 (94 cm in men, 80 cm in women) and action level 2 (102 cm in men, 88 cm in women) or to standardized BMI cut-offs (25 and 30 kg m(-2)) were estimated. Height has minimal influences on clothing size. Compared with men with trouser waist below 36 inches or women with UK dress size below 16, the age and smoking adjusted odds ratios for the risk of having at least one of the major health problems (ischaemic heart disease, hypertension or diabetes mellitus) were 3.9 (95% CI: 1.8-8.3) in men and 7.0 (95% CI: 2.5-19.4) in women who had trouser size > or =38 inches or UK dress size > or =18, respectively. CONCLUSIONS: The present study showed that men and women with large clothing size are at increased risk of ischaemic heart disease, hypertension and diabetes mellitus. Men's trouser size equal or larger than 38 in the UK and USA or 97 in Europe and women's dress size equal or larger than 18 in the UK or 16 in the USA or 48 in Europe could be used to promote self-awareness of increased health risks by the general public.

Adiposity↗
PubMed2001

Ethnic differences in anthropometric and lifestyle measures related to coronary heart disease risk between South Asian, Italian and general-population British women living in the west of Scotland.

AIMS: To compare anthropometric measurements and to define their behavioural associations in migrant and British-born South Asians (who have increased cardiovascular risk) or Italians (who have reduced cardiovascular risk), and in the general population of British women living in the west of Scotland. STUDY DESIGN: Cross-sectional survey of women aged 20-42 y, selected mainly from birth registration data, which included 63 migrant South Asians, 56 British-born South Asians, 39 migrant Italians, 51 British-born Italians, and 50 subjects representative of the general population of women, all resident in the west of Scotland. MEASUREMENTS: Height, weight, body mass index (BMI), and waist and hip circumferences. RESULTS: With age adjustment, migrant South Asians (0.88) had greater waist-to-hip ratio than British-born South Asians (0.84; P<0.05), while there was no difference between migrant (0.81) and British-born (0.79) Italian groups. Both migrant (P<0.001) and British-born South Asian (P<0.05) groups had higher waist-to-hip ratio and were about 3 cm shorter than Italian groups and the general population. Neither weight nor BMI were different between ethnic groups. Waist and hip circumferences were not different between migrant and British-born ethnic minority groups. Migrant South Asians (86.8 cm) had significantly (P<0.05) larger waist circumference than the general population (78.6 cm). British-born Italian women (103.0 cm) had larger hip circumference than the general population of women (96.4 cm), while other groups had similar hip circumferences. Additional adjustments for physical activity, smoking, alcohol consumption and parity reduced the differences in anthropometric measurements: only waist-to-hip ratio of migrant South Asians remained significantly (P<0.01) higher than that of the general population women. CONCLUSIONS: The adverse anthropometric indicators of cardiovascular risk in migrant South Asian women are substantially explained by their lifestyle factors and parity. British-born South Asian women are more similar to the general population women. Anthropometric differences between migrant or British-born Italians and the general population women are small.

Adult↗
PubMed1999

Impairment of health and quality of life using new US federal guidelines for the identification of obesity.

BACKGROUND: Estimating total burdens of disease associated with overweight and obesity has been hampered by a lack of consistent published data using standardized body mass index (BMI or Quetelet index [calculated as weight in kilograms divided by the square of the height in meters: weight (kg)/[height x (m)2]]) diagnostic criteria, and by poorly standardized reference populations. SUBJECTS AND METHODS: Symptoms of respiratory insufficiency, low back pain, non-insulin-dependent diabetes mellitus, cardiovascular risk factors, and physical functioning using SF-36 questionnaire were determined in a cross-sectional representative survey of 5887 men and 7018 women aged 20 to 59 years from the Netherlands and analyzed using BMI criteria of the National Institutes of Health and the World Health Organization guidelines. RESULTS: The prevalences of cardiovascular risks were higher in men than women, but the other health outcomes were more frequent in women. Virtually all health outcomes considered were significantly influenced by BMI. A BMI of 25 to 30 kg/m2 had a generally greater impact on odds ratios for health outcomes in women than in men. People with BMI below 25 kg/m2 were considered the reference group, with low prevalence of symptoms of obesity-related diseases and good quality of life. Between 25 to 30 kg/m2, the prevalences of these were all increased, and above 30 kg/m2 greatly increased. After adjustments for age and lifestyle factors, odds ratios (95% confidence intervals [95% CI]) in those with a BMI of 30 kg/m2 or higher were 3.5 (95% CI, 2.8-4.4) in men and 3.3 (95% CI, 2.8-3.9) in women for shortness of breath when walking upstairs, 4.6 (95% CI, 2.4-8.8) in men and 5.4 (95% CI, 2.8-10.5) in women for non-insulin-dependent diabetes mellitus, 5.5 (95% CI, 4.5-6.6) in men and 2.9 (95% CI, 2.4-3.4) in women for having at least 1 major cardiovascular risk factor. Both men and women with BMI of 30 kg/m2 or higher were twice as likely to have difficulties in performing a range of basic daily physical activities. Compared with women with BMI lower than 25 kg/m2, those with BMI of 30 kg/m2 or higher were 1.5 times more likely to have symptoms of intervertebral disk herniation. Significantly more overweight women had problems associated with low back pain, including hindrance to their daily business, absence from work, and medical consultation. CONCLUSIONS: Health risks for a range of problems are presented using the standard BMI cutoff points. Overweight and obesity are associated with increased risks of chronic diseases, secondary symptoms, and impairment of quality of life.

Adult↗
PubMed1999

Age and health indications assessed by silhouette photographs.

OBJECTIVE: To test the hypothesis that overweight and central fat distribution make people look older and have poorer health. DESIGN: We asked 201 male and 161 female observers aged 28-67 y with body mass index (BMI) 17-45 kg/m2, to estimate the age of eight silhouette photographs of female volunteers with known BMI and waist and hips. Silhouette photographs were presented individually and grouped in three trios for analysis: trio A, each subject had waist to hip ratio = 0.7, BMI for each subject was 22, 24, 29 kg/m2; trio B, each subject had BMI = 22 kg/m2, waist to hip ratio for each subject was 0.66, 0.73, 0.99; and trio C, each subject had BMI = 29 kg/m2, waist to hip ratio for each subject was 0.76, 0.88, 0.99. The observers were then asked to judge the likelihood of developing heart disease, health and longevity of the silhouettes which were presented in four pairs controlling either for BMI or waist to hip ratio. RESULTS: The age of a silhouette with BMI 22 kg/m2 was estimated to be 35 y, 24 kg/m2 to be 45 y, and 30 kg/m2 to be 55 y, when waist to hip ratio was matched at 0.7. When BMI was controlled at either 22 or 29 kg/m2, higher waist to hip ratio led to a greater age estimation. An increase from a 65 cm to 88 cm waist circumference led to an estimate of 25 y older. Narrow hips was also judged as older. The silhouettes judged the more likely to be healthy and live longer were those with the lower waist to hip ratio (by 70% observers), and the lower BMI (by 90% observers). Waist to hip ratio appeared less influential when BMI of the silhouettes was high. The observers' own BMI, age or sex had little influences on their assessments of the age and health status of the silhouette photographs. CONCLUSIONS: Using novel sets of silhouette photographs, it was shown that overweight or central fat distribution and narrow hips suggest a person is older and has poorer health: People with BMI 29.7 kg/m2 appear to be 15-18 y older than those with BMI 22.2 kg/m2, each extra cm on the waist makes women appear to look a year older, and progressively less healthy. BMI and age of the observers had little influences on the findings.

Adult↗
PubMed1999

Measurement of abdominal fat by magnetic resonance imaging, dual-energy X-ray absorptiometry and anthropometry in non-obese men and women.

OBJECTIVE: To investigate whether the dual-energy X-ray absorptiometry (DEXA) was a better predictor of abdominal fat, measured by magnetic resonance imaging (MRI) at the level of L2-L3, than anthropometric measurements in non-obese men and non-obese women. DESIGN: Observational, cross sectional study. SUBJECTS: 34 healthy subjects (17 men and 17 women) aged 20-53 y with a body mass index (BMI) < 30 kg/m2. MEASUREMENTS: Fat distribution parameters including waist circumference and waist-to-hip ratio (WHR); intra abdominal fat (IAF) by MRI; and central abdominal fat (CAF) by DEXA. RESULTS: Measurement of IAF by MRI, was highly correlated to the CAF measured by DEXA. In men, both waist circumference and WHR had similar correlation to IAF as DEXA. In women, waist circumference was less well correlated with IAF than DEXA, and the WHR had a weaker non significant correlation with IAF. CONCLUSIONS: In non-obese men; DEXA, waist circumference and WHR can predict IAF equally well, while in non-obese women, DEXA is superior to waist circumference and much better than WHR.

Abdomen↗
PubMed1999

Effects of a thiazolidinedione compound on body fat and fat distribution of patients with type 2 diabetes.

OBJECTIVE: To examine the effects of a thiazolidinedione (600 mg troglitazone) insulin-sensitizing treatment on total body fat measured by underwater weighing, on intra- and extra-abdominal fat mass using magnetic resonance imaging (MRI), and on anthropometric measures. RESEARCH DESIGN AND METHODS: Type 2 diabetic outpatients were studied in a double-blind randomized trial carried out at Glasgow Royal Infirmary, Scotland. RESULTS: Groups who received troglitazone (8 men, 3 women) and placebo (8 men, 2 women) were well matched for age, BMI, total body fat percentage by underwater weighing, and intra-abdominal fat (kilograms) by MRI. After 12 weeks, body weight changes in the troglitazone group (mean +0.66 kg [95% CI -0.71 to 2.04], P = 0.31) and the placebo group (mean +0.25 kg [-0.64 to 1.13], P = 0.55) were not statistically different. Changes in total body fat with troglitazone (mean +1.02% body wt [-1.13 to 3.17], P = 0.32) and placebo (mean -0.54% body wt [-1.68 to 0.59], P = 0.31) were not significantly different. There was, however, a decrease in intra-abdominal fat mass in the troglitazone-treated group (mean -0.47 kg [-0.79 to -0.13], P = 0.01), and this was significantly different (P = 0.03) from placebo treatment (mean -0.41 kg [-0.77 to -0.05]). CONCLUSIONS: Treatment with the thiazolidinedione troglitazone in human patients with type 2 diabetes decreases intra-abdominal fat mass but does not affect total body fat or weight. This potentially valuable effect points to a differential action on insulin sensitivity in different adipose tissue depots.

Abdomen↗
PubMed1998

Impairment of health and quality of life in people with large waist circumference.

BACKGROUND: Symptoms and secondary disorders associated with excess central fat distribution are being increasingly recognised. We aimed to define the symptoms and assess risks of chronic disorders in people with large waist circumferences. METHODS: We did a cross-sectional study of 5887 men and 7018 women aged 20-59 years from the general population of Maastricht, Amsterdam, and Doetinchem, Netherlands. We assessed in health centres respiratory insufficiency, low back pain, degree of physical function, presence of non-insulin-dependent diabetes, and cardiovascular risk factors. We measured bodyweight, body-mass index, and waist circumference by action levels (men: less than action level 1 <94.0 cm, action levels 1-2 94.0-101.9 cm, more than action level 2 > or =102.0 cm; women: less than action level 1 <80.0 cm, action levels 1-2 80.0-87.9 cm) more than action level 2 > or =88.0 cm). The reference group were people with waist circumferences lower than action level 1. FINDINGS: All symptoms and risks increased among participants higher than action level 2, after adjustment for age and lifestyle, by 3.1 (95% CI 2.5-3.7) in men and 2.7 (2.3-3.1) in women for shortness of breath when walking upstairs; 4.5 (2.5-7.8) and 3.8 (1.9-7.3) for non-insulin-dependent diabetes; and 4.2 (3.6-5.0) and 2.8 (2.4-3.2) for at least one major cardiovascular risk factor. Above action level 2, compared with the reference group, men and women were at twice the risk of difficulties in everyday activities, women were 1.5 times more likely to have low back pain or symptoms of intervertebral disc herniation, with secondary problems including hindrance to daily activities. INTERPRETATION: People with large waist circumferences have excess burden of ill health. Waist action levels could be useful for health promotion to raise awareness of the need for weight management.

Abdomen↗
PubMed1998

Associations of body composition with type 2 diabetes mellitus.

The aims of this study were to establish the associations of stature, body mass index, waist to hip ratio, and waist circumference with Type 2 (non-insulin-dependent) diabetes mellitus in a random sample of 5887 men and 7018 women aged 20-59 years in a cross-sectional study set in The Netherlands. The crude prevalence of Type 2 diabetes (overall 1.58% in men, 0.94% in women) was significantly (p < 0.01) higher in shorter subjects and those with high body mass index, high waist to hip ratio, and larger waist circumference. Odds ratios and 95% confidence intervals (95% CI) were adjusted for age, cigarette smoking, alcohol consumption, physical activity, and education. Compared to the tallest tertile of height, odds ratios for Type 2 diabetes were 4.4 (95% CI: 1.3 to 11.5) in men and 1.6 (95% CI: 0.8 to 3.2) in women whose height was in the shortest tertile. Compared to the lowest tertile, odds ratios for Type 2 diabetes were 18.4 (95% CI: 4.3 to 78.5) in men and 5.3 (95% CI: 2.0 to 14.0) in women with waist to hip ratio in the highest tertile, 4.1 (95% CI: 2.0 to 8.4) in men and 2.1 (95% CI: 1.0 to 4.2) in women with body mass index in the highest tertile, and 4.9 (95% CI: 2.1 to 11.7) in men and 2.7 (95% CI: 1.2 to 5.9) in women with waist circumference in the highest tertile. In conclusion, although in longitudinal studies waist is a powerful predictor of diabetes incidence, Type 2 diabetes in a cross-sectional survey is associated with shortness in stature, as well as large waist circumference and high body mass index, and particularly strongly with high waist to hip ratio, suggesting that the development of Type 2 diabetes may modify hip circumference independently of body fat.

Adult↗
PubMed1998

Self-reported waist circumference compared with the 'Waist Watcher' tape-measure to identify individuals at increased health risk through intra-abdominal fat accumulation.

We evaluated the accuracy of self-reported home-assessed and self-measured waist circumference in 101 men and eighty-three women aged 28-67 years. The main outcome measures were subjects' self-reported and self-measured waist circumference, and self-classification according to the previously defined waist action level 1 (940 mm in men, 800 mm in women) and action level 2 (1020 mm in men, 880 mm in women), and waist circumference measured by the investigator using the 'Waist Watcher' tape-measure, as the reference method. The mean errors (95% CI limits of agreement) for subjects' self-reported waist circumference (self-reported minus reference; mm) were -67 (95% CI -210, 77) in men and -43 (95% CI -211, 123) in women, and for self-measured waist circumference (mm) using the 'Waist Watcher' (self-measured minus reference) were -5 (95% CI -62, 52) in men and -4 (95% CI -50, 42) in women. The proportions of subjects classified into waist action level 1 or action level 2 by the investigator were used as the reference method. Self-reported waist circumference of men and women respectively would be classified correctly in different categories based on action level 1 with sensitivities of 58.3 and 78.7%, and specificities of 92.5 and 91.7%, and action level 2 with sensitivities of 35.3 and 44.9%, and specificities of 98.5 and 90.7%. Using the 'Waist Watcher' with different colour bands based on the action levels, male and female subjects respectively classified themselves into correct categories according to action level 1 with sensitivities of 100 and 95.7%, and specificities of 95.1 and 97.2%, and according to action level 2 with sensitivities of 97.1 and 100%, and specificities of 100% for both sexes. Only 2% of the sample misclassified themselves into the wrong categories according to waist circumference action levels. In conclusion, people tend to underestimate their waist circumference, but the 'Waist Watcher' tape-measure offers advantages over self-reported home-assessed measurement, and may be used as a screening tool for self-classifying the risk of ill health through intra-abdominal fat accumulation.

Abdomen↗
PubMed1998

Associations of indices of adiposity with atherogenic lipoprotein subfractions.

OBJECTIVE: To investigate the associations of indices of adiposity with cardiovascular risk factors. SUBJECTS: 93 men and 98 women aged 18-69 y. OUTCOME MEASURES: Body mass index (BMI), waist to hip ratio (WHR), waist circumference, waist to height ratio, blood pressure, fasting concentrations of blood glucose, insulin, plasma lipids and lipoprotein subfractions, apoproteins, lipoprotein(a) and post-heparin lipases. RESULTS: BMI and waist showed similar associations (P < 0.01) with a cluster of major cardiovascular risk factors including total cholesterol, low density lipoprotein-cholesterol and very low density lipoprotein-cholesterol in men, and ratio of low density lipoprotein-/high density lipoprotein-cholesterol for both genders. Large waist circumference was significantly (P < 0.01) associated (controlled for age and smoking) with features of the metabolic syndrome, including raised insulin concentration (men: r=0.37, women: r=0.49), reduced high density lipoprotein2 (men: r=-0.30, women: r=-0.34), increased very low density lipoprotein1 mass (men: r=0.31, women: r=0.42), raised small, dense low density lipoprotein (men: r=0.30, women: r=0.31), elevated blood pressure (men: r=0.27, women: r=0.28), increased triglyceride (men: r=0.43, women: r=0.48) and apolipoprotein-B (men: r=0.32, women: r=0.35). Waist circumference also correlated with hepatic lipase/lipoprotein lipase ratio in women (r=0.52). Height adjustment did not substantially change relationships between waist circumference and risk factors. WHR correlated with fewer risk factors. CONCLUSION: For the purpose of health promotion to prevent cardiovascular disease associated with overweight and intra-abdominal fat accumulation, the general public should be advised to be aware of the risk associated with large waist circumference.

Adipose Tissue↗
PubMed1998

Separate associations of waist and hip circumference with lifestyle factors.

OBJECTIVE: To study the associations of lifestyle factors with waist circumference 'Action Levels', hip circumference and body mass index. DESIGN: Cross-sectional study in a random sample of 5887 men and 7018 women aged 20-59 years, selected from the civil registries of Amsterdam, Maastricht and Doetinchem, The Netherlands. RESULTS: Results were compared to those in low health risk reference groups: non-smokers, occasional drinkers, highest educated, physically active, employed subjects, women who had no live births, or 20-29-year-olds. In multivariate logistic regression analysis, odds ratios (95% confidence interval) for having a waist above 'Action Level 2' (> or =102 cm in men, > or =88 cm in women) were significantly lower in smokers, and higher in heavy drinkers, inactive subjects, unemployed people, those educated below secondary level, women who had > or =3 live births, and older age. Mean waist-to-hip ratio adjusted for body mass index and age were higher in these groups. Residual analysis showed that the likelihood of having larger waist than expected from their body mass index was 1.2 times (1.1-1.4) in male smokers, 1.4 times (1.2-1.7) in male and 1.7 times (1.3-2.2) in female heavy drinkers, 1.6 times (1.5-1.8) in inactive men, and 1.3 times (1.1-1.5) in unemployed women. The risk of having smaller hips than expected from body mass index was 1.2 times (1.1-1.4) in male and 1.2 times (1.0-1.3) in female smokers, 1.2 times (1.1-1.3) in men and 1.1 times (1.0-1.2) in women who were inactive. CONCLUSIONS: Each lifestyle factor influences the size of waist and the hips differently, and understanding these influences is important for health promotion directed at the general public. Lifestyle modifications such as smoking cessation, reduced drinking, and a more physically active lifestyle should all be encouraged, leading to an overall healthier body shape.

Adult↗
PubMed1998

Natural sporting ability and predisposition to cardiovascular disorders.

We tested the hypothesis that people with a natural ability in 'power sports' (a presumed marker for predominance of type 2, glycolytic muscle fibres) might have increased risks of coronary heart disease (CHD) compared to those with a natural ability in 'endurance sports' (as a marker for predominance of type 1, oxidative muscle fibres). We examined subsequent cardiovascular disorders retrospectively in 231 male former soldiers, aged 34-87 years, who had undergone a course in physical training in the Army School of Physical Training, Aldershot, UK, who assessed themselves as having natural ability in either power (n = 107) or endurance (n = 124) sports. The proportion with CHD, defined as angina and/or coronary angioplasty and/or coronary artery bypass graft and/or heart attack was 18.7% in the 'power group' vs. 9.7% in the 'endurance group' (difference: chi 2 = 3.9, p = 0.05). The proportions with CHD and/or risk factors rose to 39.3% in the 'power group' vs. 25.8% in the 'endurance group' (difference: chi 2 = 4.8, p = 0.03). Under logistic regression analysis, compared to the 'endurance group', the 'power group' had 2.2 (95% CI: 1.00-4.63) the risk of developing CHD, and 1.86 (95% confidence interval: 1.06 to 3.25) the risk of developing CHD and/or risk factors. Men with a natural ability in 'power sports' are at increased risk of developing cardiovascular disorders, compared to men with a natural ability in 'endurance sports'. A predominance of type 2, glycolytic muscle fibres, presumably of genetic origin, may predispose to cardiovascular disorders.

Adult↗
PubMed1998

Quality of life in relation to overweight and body fat distribution.

OBJECTIVES: This study quantified the impairment of quality of life attributable to body fatness by using the standardized SF-36 Health Survey. METHODS: Tertiles of waist circumference and body mass index (BMI) in 1885 men and 2156 women aged 20 to 59 years in the Netherlands in 1995 were compared. RESULTS: The odds ratios and 95% confidence intervals of subjects with the largest waist circumferences, compared with those in the lowest tertile, were 1.8 (1.3, 2.4) in men and 2.2 (1.7, 2.9) in women with difficulties in bending, kneeling, or stooping; 2.2 (1.4, 3.7) in men and 1.7 (1.2, 2.6) in women with difficulties in walking 500 m; and 1.3 (1.0, 1.9) in men and 1.5 (1.1, 1.9) in women with difficulties in lifting or carrying groceries. Anthropometric measures were less strongly associated with social functioning, role limitations due to physical or emotional problems, mental health, vitality, pain, or health change in 1 year. The relationship between quality of life measures and BMI were similar to those between quality of life measures and waist circumference. CONCLUSIONS: Large waist circumferences and high BMIs are more likely to be associated with impaired quality of life and disability affecting basic activities of daily living.

Activities of Daily Living↗
PubMed1997

Weight loss with high and low carbohydrate 1200 kcal diets in free living women.

This randomised controlled trial examined anthropometric changes and cardiovascular benefits of six months of weight management in 110 free living women, aged 18-68 y and BMI 25-50 kg/m2, who received 1200 kcal/d diet treatments of either high (58% energy, n = 57) or low (35% energy, n = 53) carbohydrate (CHO) content. Body weight, plasma total, HDL and LDL cholesterol, triglyceride and blood pressure were measured. Examination at three months showed women on high CHO lost (mean +/- s.e.m) 4.3 +/- 0.5 kg and those on low CHO lost 5.6 +/- 0.6 kg of body weight. Changes in risk factors did not significantly differ between the two diet treatments throughout the study. However those on high CHO diets significantly lowered their plasma total cholesterol by 0.33 mmol/l (95% CI: 0.10, 0.55), LDL cholesterol by 0.23 mmol/l (0.02, 0.43) and HDL cholesterol by 0.05 mmol/l (0.03, 0.10), while women on low CHO diets lowered only plasma triglyceride by 0.28 mmol/l (0.08, 0.48). Blood pressure did not change significantly on either diet. After six months, women on high CHO lost 5.6 +/- 0.8 kg and those on low CHO lost 6.8 +/- 0.8 kg. On the high CHO diet, total cholesterol remained significantly below the baseline value at 0.34 mmol/l (0.13, 0.56), triglyceride was significantly lowered by 0.27 mmol/l (0.10, 0.45), and HDL cholesterol returned to the baseline value. On the low CHO diet, triglyceride remained the only risk factor to be significantly improved. A subgroup of 46 postmenopausal women lost significantly (P < 0.05) more weight on the low CHO diet than high CHO diet. In conclusion, these results provided some support for preferring a high CHO diet to a lower CHO approach in weight management, from the point of view of risk reduction, but do not indicate a consistently more rapid weight loss with either diet.

Adolescent↗
PubMed1997

Skeletal proportions and metabolic disorders in adults.

OBJECTIVE: The present study investigated the associations of stature, lower leg length (LLL) and demi-arm span (demi-AS) with major predisposing cardiovascular risk factors and coronary heart disease. STUDY DESIGN AND SUBJECTS: Cross-sectional study set at Glasgow Royal Infirmary of a subsample of 543 men and 646 women aged 25-66 y from the random MONICA sample. ASSOCIATED MEASURES: LLL, demi-AS, blood pressure, plasma total cholesterol, diabetes mellitus and coronary heart disease (angina, angioplasty, heart attack, and coronary artery bypass graft). RESULTS: The numbers (and proportions) of men and women, respectively, with hypertension were 126 (23.6%) and 80 (14.0%), hypercholesterolaemia 155 (29.0%) and 171 (30.1%), coronary heart disease 53 (10.1%) and 47 (8.4%), and diabetes 15 (2.9%) and 9 (1.6%). Results were adjusted for age, social class and smoking. Analysis of variance showed that in men, shortness of height, LLL or demi-AS were all associated significantly (P < 0.05) with hypercholesterolaemia. Long LLL, high ratios of LLL:height or LLL:demi-As were associated significantly (P < 0.05) with diabetes mellitus. In women, shortness of height or LLL were associated with significantly (P < 0.05) with coronary heart disease. High ratio of demi-AS:height or low ratio of LLL:demi-AS was associated significantly (P < 0.05) with coronary heart disease. CONCLUSIONS: Short stature and limb lengths, and also altered skeletal proportions, which may reflect interrupted early growth, are associated with several metabolic disorders. Skeletal disproportion associates with diabetes in men and coronary heart disease in women.

Adult↗
PubMed1997

The influences of height and age on waist circumference as an index of adiposity in adults.

OBJECTIVES: To assess the influences of height and age on the differences in waist circumference between individuals of different stature. SUBJECTS: 3319 males and 4358 females from four studies in the UK and the Netherlands. MEASUREMENTS: Waist circumference, body weight, height, and age. RESULTS: Linear regression analysis of log10 height as the independent variable on log10 waist as the dependent variable was used to determine the optimal index powers (OIP) (p) to minimize the influence of height in the relationships of waist/height(p). Six out of eight samples of men and women had OIP of height not significantly different from zero, with the remaining two groups had OIP between 0.15-0.58, indicating that height had very limited influence on the differences in waist circumference measurement between individuals. Age adjustment increased the relationship between waist and height, with OIP of 0.19-0.89 in men and 0.02-0.58 in women. Without age adjustment, height explained 0.3-3.5% and 0.1-2.5% variance in waist in men and in women respectively, and the corresponding variances were 0.4-7.5% in men and 0.0-2.6% in women with age adjustment. A similar analysis of weight and height showed the OIP of height in weight/height(p) ratio ranged from 1.32-2.25 in men, and 0.87-1.74 in women without age adjustment, and from 1.47-2.24 in men and 1.25-1.96 in women with age adjustment. CONCLUSION: Height and age had limited influences on the differences in waist between Caucasian subjects of different stature. Waist alone may be used to indicate adiposity or to reflect metabolic risk factors. In contrast, the influence of height on body weight is important.

Adult↗