No abstract

simple anthropometric measurement, such as waist circumference (WC) or waist to hip ratio (WHR), is widely used in clinical practice as a surrogate for central obesity in order to assess health status. 1,2 However, for a given WC, body fat distribution differs significantly according to gender, menopausal status, age, and so forth. 3,4 Particularly in premenopausal women, subcutaneous fat is relatively predominant over abdominal visceral fats, 5 and so using WC to evaluate visceral obesity could underestimate metabolic disorders.Metabolic syndrome (MetS) is a major public health challenge because of its implications in the increased risk of type 2 diabetes and cardiovascular disease (CVD). 6,7 During the past decade, various sets of diagnostic criteria for MetS have been proposed [8][9][10][11] and all share the major metabolic risk factors (RF) such as abdominal obesity, insulin resistance/glucose intolerance, dyslipidemia and hypertension. However, there are 2 major differences in the organization of the criteria and the emphasis on excessive adiposity. [8][9][10][11] Thus, discrepant cases are often reported in studies of the prevalence of MetS, or in the subjects' characteristics classified to MetS, depending on the definition used. 12-14 Currently, the International Diabetes Federation (IDF) criteria, 11 which define WC as an obligatory factor for diagnosing MetS, are under discussion for thier inability to detect metabolically abnormal but non-obese individuals. 12,15 In addition, a WHO expert consultation addressed the fact that Asians generally have a higher percentage of body fat and show greater abdominal obesity at a lower body mass index (BMI) than Caucasians. 16 The consultation also identified an additional trigger point for public health action or clinical intervention as being 23 kg/m 2 BMI because the relative risk for type 2 diabetes or CVD in Asian populations is substantial, even below 25 kg/m 2 BMI.Therefore, in order to evaluate the risk of MetS in premenopausal Asian women, the present study aimed to (a) elucidate the best marker of central obesity among the obesity-related anthropometric indices including computed tomography (CT) results, (b) define the optimal cut-off point of visceral fat area (VFA) in premenopausal women and (c) examine whether or not the WC derived from the cut-off point of the VFA can also reflect the features of MetS, particularly in subjects with BMI ≥23 kg/m 2 . J 2008; 72: 1308 -1315 (Received November 9, 2007 revised manuscript received March 12, 2008; accepted April 4, 2008 Background In clinical practice, using the patient's waist circumference (WC) to evaluate visceral obesity may underestimate disorders with a metabolic origin. This study examined whether or not the WC derived from the cut-off point of the visceral fat area (VFA) can reflect the features of metabolic syndrome (MetS) in premenopausal women. Circ Methods and ResultsComputed tomography-scanned VFA, MetS components and the concentrations of highsensitivity C-reactive protein (CRP) and adipone...

Application of PEEP of 5 cmH(2)O should be considered in PCV during laparoscopic surgeries to decrease intraoperative atelectasis caused by pneumoperitoneum to improve gas exchange and oxygenation.

Dyslipidemia is implicated in increased cardiovascular risk associated with chronic kidney disease (CKD) and in the progression of renal damage. This study compared 4 different lipid-related ratios (total cholesterol [TC]/high-density lipoprotein cholesterol [HDL-C], triglyceride [TG]/HDL-C, calculated low-density lipoprotein cholesterol [c-LDL-C]/HDL-C, and non-HDL-C/HDL-C ratio) for prediction of CKD stage 3 or more to investigate the association between them. This cross-sectional study included 8,650 adults who participated in the 2007-2008 Korean National Health and Nutrition Examination Survey. The overall prevalence of CKD stage 3 or more was 6.4%. For TG/HDL-C, the prevalence with CKD stage 3 or more increased with increasing quartile group in both sexes (P value for trend = 0.046 in men, 0.002 in women) while other lipid-related ratios showed increasing prevalence only in women. In comparison with the lowest quartile of the lipid-related ratios, only the fourth quartile of TG/HDL-C was associated with the prevalence of CKD stage 3 or more in both sexes after adjustment for multiple covariates (odds ratio [OR] for TG/HDL-C-Q4, 1.82; 95% CI [confidence interval], 1.09-3.03 in men, OR 2.45; 95% CI, 1.52-3.95 in women). In conclusion, TG/HDL-C is the only lipid-related ratio that is independently associated with CKD stage 3 or more in both sexes of Koreans.