The Obesity Paradox in Chronic Heart Disease and Chronic Obstructive Pulmonary Disease

Ravindran, Suganya Giri; Saha, Debistuti; Iqbal, Iffat; Jhaveri, Sharan; Avanthika, Chaithanya; Naagendran, Mridula Sree; Bethineedi, Lakshmi Deepak; Santhosh, Tony

doi:10.7759/cureus.25674

Cited by 16 publications

(13 citation statements)

References 102 publications

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“…Early onset adiposity has been implicated in the pathogenesis of PCOS and can be predictive of a more severe phenotype. It is also linked to the development of low-grade inflammation, greater cardiometabolic dysfunction and future risk of atherosclerosis [12][13][14][15]. Our data shows that as an indicator of visceral fat function, VAI correlates well with severity of menstrual dysfunction and ovarian dysmorphology, and seems to be predictive of impaired glucose tolerance, thus indicating propensity for development of diabetes in the future.…”

Section: Discussionmentioning

confidence: 63%

Visceral Adiposity Index as an Indicator for Menstrual Disturbance, Hormonal and Metabolic Dysfunction in Polycystic Ovarian Syndrome

Sarkar¹,

Kaur²,

Gupta³

et al. 2022

Cureus

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Background: Increase in visceral adiposity is characteristic of polycystic ovarian syndrome (PCOS) and is the main cause of insulin resistance and hyperandrogenism. This study tried to compare the visceral adiposity index (VAI) in PCOS women and control population, thereby exploring its correlation with ovarian morphology, hormonal and metabolic dysfunction.Materials and Methods: Reproductive-age women who fulfilled the Rotterdam criteria for PCOS constituted the cases. Control population consisted of the same number of non-PCOS women. History of menstrual irregularity and features of hyperandrogenism were noted. Overnight fasting serum hormonal profile on second day of the cycle, oral glucose tolerance test (OGTT) and serum fasting insulin and lipid profile were obtained. Ultrasound evaluation was done simultaneously. Free androgen index (FAI), homeostatic model assessment of insulin resistance (HOMA-IR) and VAI were calculated.Results: Serum androgen levels and OGTT were greater in PCOS women. No significant difference was noted in serum fasting glucose, fasting insulin and lipid profile between cases and controls. Both systolic and diastolic blood pressures were significantly higher among women with PCOS. Mean ovarian volume, antral follicle count, FAI and HOMA-IR were higher in PCOS women. VAI was significantly higher in cases compared to controls. VAI demonstrated a strong negative correlation with number of menstrual cycles per year. Increasing VAI was associated with longer menstrual cycles and correlated positively with greater severity of anovulation. VAI also showed highly significant correlation with fasting blood glucose and statistically significant moderately strong positive correlation with OGTT values at two hours post glucose challenge, systolic blood pressure and mean ovarian volume. There was no demonstrable correlation between androgen levels or HOMA-IR values.Conclusion: VAI is higher in women with PCOS. It correlates positively with features of disease severity and ovarian morphology. An assessment of VAI in PCOS women could be predictive of a greater propensity for development of classical metabolic risk factors.

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Section: Discussionmentioning

confidence: 63%

Visceral Adiposity Index as an Indicator for Menstrual Disturbance, Hormonal and Metabolic Dysfunction in Polycystic Ovarian Syndrome

Sarkar¹,

Kaur²,

Gupta³

et al. 2022

Cureus

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“…In recent years, evidence has shown that fat tissue accumulation may be bene cial to survival rate, which has become known as the "obesity paradox" [23]. Numerous studies have revealed that fat storage is a protective factor associated with lower mortality risk in patients with advanced CKD [24,25].…”

Section: Sensitivity Analysismentioning

confidence: 99%

Composite Lipid Parameters are Optimal in Predicting Chronic Kidney Disease Prognosis

Chen,

Xiao,

Chen

et al. 2023

Preprint

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Background Lipid management in clinic is critical to the prevention and treatment of CKD, while the manifestations of fat metabolism vary in type and have flexible correlations with CKD prognosis. Purpose Explore correlations between the widely used indicators of lipid metabolism in clinic and CKD prognosis; provide a reference for lipid management and treatment among non-dialysis CKD stages 3–5. Methods This is a retrospective cohort study utilizing the SMP-CKD database of 794 individuals with CKD stages 3–5. Variables with P < 0.10 in univariate Poisson models were induced to construct several timescale-based Poisson models with a stepwise regression according to lipid manifestation categories. We selected the best model via AIC, AUC and ROC and confirmed the independent relative exposures via RRs (95% CI). Subgroup analysis and sensitivity analysis were performed to assess the interaction effects and robustness. Results 255 individuals reached the composite outcome. Median follow-up duration was 2.03 [1.06, 3.19] years. Median age was 58.35 [48.50, 66.69] years with a median eGFR of 33.68 [17.55, 47.81] ml/min/1.73 m2. The fully adjusted category-based Poisson Model 4 in Dataset 5 had the largest AUC (0.717 [0.684, 0.751]) with P for ROC < 0.05. TC (1.158 [1.056, 1.271], P = 0.002) and PBF (0.948 [0.906, 0.992], P = 0.021) were significant factors of composite outcome and no manual measurements had any statistically significance. The

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“…Obesity, measured by the waist, hips, and body mass index (BMI) [ 8 ], is a significant risk factor for heart disease [ 4 , 9 ]. Approximately half of Americans (47%) have at least one of these obesity indicators, regardless of other sociodemographic, lifestyle, and clinical factors that increase the risk of heart disease [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Heart Disease and Obesity Indicators Among Adults: A Secondary Data Analysis

Alwadeai¹,

Almeshari²,

Alghamdi³

et al. 2023

Cureus

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BackgroundBody mass index (BMI), waist circumference (WC), and hip circumference (HC) determine obesity. Several studies have examined the association between obesity and many diseases, including heart disease, and found it to be a substantial risk factor. However, the relationship between heart disease and obesity has not been investigated. This study investigated the relationship between heart disease and obesity indicators among adults encompassing sociodemographic and lifestyle factors. MethodologyThis cross-sectional study included data from 3,574 individuals who participated in the 2011-2014 National Survey of Midlife Development in the United States refresher. The presence or absence of heart conditions such as irregular heartbeat, heart murmur, heart attack, and heart failure was determined using selfreported questionnaires. The association between heart disease and obesity indicators such as BMI, WC, HC, and waist-to-hip ratio (WHR) was investigated using linear regression. ResultsAfter controlling for all factors, the findings demonstrated a significant relationship between heart disease and BMI, WC, and HC high scores of 1.12 kg/m 2 , 0.63 inches, and 0.81 inches, respectively. A higher score in all obesity indicators was linked to being 65 years or older; male gender (for HC); having a school/college level of education; being unmarried, divorced, or widowed; having a history of smoking; and avoiding alcohol use. ConclusionsHeart disease and sociodemographic and lifestyle factors are substantially associated with a high score in all obesity indicators. The findings of this study are important because they can assist healthcare providers in implementing different therapies to prevent high BMI, WC, HC, and WHR.

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The Obesity Paradox in Chronic Heart Disease and Chronic Obstructive Pulmonary Disease

Cited by 16 publications

References 102 publications

Visceral Adiposity Index as an Indicator for Menstrual Disturbance, Hormonal and Metabolic Dysfunction in Polycystic Ovarian Syndrome

Visceral Adiposity Index as an Indicator for Menstrual Disturbance, Hormonal and Metabolic Dysfunction in Polycystic Ovarian Syndrome

Composite Lipid Parameters are Optimal in Predicting Chronic Kidney Disease Prognosis

Relationship Between Heart Disease and Obesity Indicators Among Adults: A Secondary Data Analysis

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