Central Obesity and the Metabolic Syndrome: Implications for Primary Care Providers

Appel, Susan J.; Jones, Ellen; Kennedy‐Malone, Laurie

doi:10.1111/j.1745-7599.2004.tb00456.x

Cited by 39 publications

(24 citation statements)

References 59 publications

(49 reference statements)

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“…For example, an examination of adolescents as well as adults should include obtaining a waist measurement along with other commonly performed screening techniques. Specifically, well female physicals should include measurement of waist circumference with other screenings, such as breast and gynecological exams (Appel, Jones, & Kennedy-Malone, 2004). Prevention programs to promote physical activity and encourage weight management are imperative in order to reduce risk for the development of central obesity, the metabolic syndrome, and type 2 diabetes.…”

Section: Implications For Practicementioning

confidence: 99%

Central Obesity, the Metabolic Syndrome, and Plasminogen Activator Inhibitor‐1 in Young Adults

Appel¹,

Harrell²,

Davenport³

2005

Journal of the American Academy of Nurse Practitioners

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Purpose To determine the association of central obesity with the components of the metabolic syndrome (i.e., hyperinsulinemia, hypertension, hypertriglyceridemia, low levels of high‐density lipoprotein cholesterol [HDL‐C]) and plasma levels of plasminogen activator inhibitor‐1 (PAI‐1) in young adults. We hypothesized that central obesity as determined by waist circumference would be predictive of components of the metabolic syndrome and of PAI‐1. Data sources Participants in this descriptive study consisted of 85 healthy young adults aged 19–22 years, 62% women who fasted for 12 h prior to data collection in the General Clinical Research Center at a major university hospital medical center in the southeastern United States. Conclusions The majority of the participants had one or more components of the metabolic syndrome (n= 43, 51%). Central obesity was present in 14.1% and was more common in women than men (χ2= 5.11; p= 0.021). Central obesity was significantly and positively correlated with elevated blood pressure (BP) and levels of insulin and PAI‐1 while being negatively correlated with HDL‐C. In multiple regression analyses, diastolic BP, insulin, and HDL‐C were predictors of waist circumference (R2= 0.615). In a separate multiple regression, PAI‐1 was predicted by waist circumference (R2= 0.331). Implications for practice Many otherwise healthy young adults have one or more components of the metabolic syndrome. Assessment and institution of preventative measures for obesity and the components of the metabolic syndrome should begin in childhood. Furthermore, determination of waist circumference especially in young women may aid the practitioner to identify those at risk for the metabolic syndrome earlier in their disease trajectory. Furthermore, insulin resistance is believed to occur initially in the trajectory of the metabolic syndrome, making it a principal contender for suitable interventions to reduce risk for both type 2 diabetes and cardiovascular disease (CVD). Homeostatic model assessment for insulin resistance was used to assess for insulin resistance among the euglycemic participants. Recording the presence of insulin resistance will aid the practitioner in determining if a low‐risk patient is in peril for development of type 2 diabetes and/or CVD. Early cardiovascular risk recognition is vital to clinical practice as it allows more time for the practitioner to counsel patients for the essential planning needed to make lifestyle changes.

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Section: Implications For Practicementioning

confidence: 99%

Central Obesity, the Metabolic Syndrome, and Plasminogen Activator Inhibitor‐1 in Young Adults

Appel¹,

Harrell²,

Davenport³

2005

Journal of the American Academy of Nurse Practitioners

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“…It is more significant than generalized obesity for the development of metabolic syndrome (Appel, Jones, & Kennedy-Malone, 2004). It is more significant than generalized obesity for the development of metabolic syndrome (Appel, Jones, & Kennedy-Malone, 2004).…”

Section: Primary Prevention Practicesmentioning

confidence: 99%

Risk of Metabolic Syndrome, Cardiovascular Disease, and Diabetes in Androgen Deprivation Therapy

Leahy¹

2008

Clinical Journal of Oncology Nursing

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Men with prostate cancer may be at increased risk for metabolic syndrome, cardiovascular disease, and diabetes from androgen deprivation therapy (ADT). This article reviews current literature related to potential adverse effects of using ADT for localized prostate cancer. The use of gonadotropin-releasing hormone agonist therapy for prostate cancer in the early 1990s compared to the late 1990s is addressed. Oncology nurses play an important role in educating men about strategies for preventing and reducing side effects of cancer treatment. Therefore, having knowledge regarding the impact of hormone therapy on men's health will be important to prostate cancer survivors.

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“…Considering the global burden of obesity and its co morbidities, emphasis is now shifting towards a preventive approach as well as risk stratification for the identification of high risk individuals and lifestyle changes [6,7]. Because obesity is a common denominator in the development of lifestyle disorders, accurately calculating body fat % using field methods has now become a necessity.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Skin Fold Thickness Prediction Equation for Asian Indians Using Hydrodensitometry

Shenoy¹,

Shrivastava²,

Sandhu³

et al. 2016

Journal of Obesity and Overweight

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There is increasing evidence that the associations between body mass index (BMI), body fat percentage (body fat %) and body fat distribution differ across populations [1]. Particularly in the Asian population, a specific BMI reflects a higher percentage of body fat than in white or European populations [1]. Obesity is defined as an excessive amount of adipose tissue with body fat % ≥ 25% in males, ≥32% in females [2]. BMI which is essentially weight (kg)/ height 2 (m 2 ), is a measure of relative weight and is an acceptable proxy for thinness and fatness and has been directly related to health risks and death rates in many populations [1]. Thus BMI is often used as a surrogate measure of obesity, because of the difficulties in accurately estimating body fat %, though BMI fails to distinguish between body fat and lean mass. Considering the relation of BMI cut offs with health risks, the cut off values for obesity using BMI were established as BMI Method: 137 healthy people (77 males and 60 females), in the age group of 30-60 years were included in the study. With hydrodensitometry, anthropometric measurements such as height, weight, 10 skin folds thickness sites, 5 sites of circumference, 5 sites of bone breadths and DEXA scans were taken as variables. A linear regression model was then created for both males and females, with body fat % calculated by hydrodensitometry used as a dependent variable and other anthropometric measurements and DEXA results used as independent variables.Results: 4 new body fat estimation models, 2 for males and 2 for females were obtained for Asian Indians with R2 of 0.90 and 0.71 for males and 0.90 and 0.72 for females respectively. Conclusion: The new prediction equations for body fat % estimation, which were derived and internally validated in an adult Indian population revealing a lower error difference than previously developed models.

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Central Obesity and the Metabolic Syndrome: Implications for Primary Care Providers

Abstract: Abstract:Purpose: To describe screening measures that will determine which clients are at risk For the metabolic syndrome, common manifestations of the syndrome, preventive diagnostic considerations, and management and treatment options that primary care providers can implement.

Cited by 39 publications

References 59 publications

Central Obesity, the Metabolic Syndrome, and Plasminogen Activator Inhibitor‐1 in Young Adults

Central Obesity, the Metabolic Syndrome, and Plasminogen Activator Inhibitor‐1 in Young Adults

Risk of Metabolic Syndrome, Cardiovascular Disease, and Diabetes in Androgen Deprivation Therapy

Development and Validation of a Skin Fold Thickness Prediction Equation for Asian Indians Using Hydrodensitometry

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