Mechanisms of body fat distribution and gluteal-femoral fat protection against metabolic disorders

PurposeIndians face a higher risk of cardiometabolic diseases (CMDs) at the same BMI compared to Caucasians. This study explored the use of the Dual Metric Obesity Criteria (DMOC), combining central obesity (CO) indices with BMI, to assess sex-specific associations with CMDs in rural Indians.MethodsBaseline cross-sectional data from 3,397 participants aged ≥45 from the Centre for Brain Research-Srinivaspura Aging, Neuro Senescence and COGnition (CBR-SANSCOG) study were analysed. Five obesity indices were examined: BMI, Waist Circumference, Waist-Hip Ratio (WHR), Waist-Height Ratio (WHtR), and Visceral Fat Percentage. Cohen’s Kappa assessed the agreement between BMI and CO indices. Participants were classified based on BMI and CO status: NWNC (Normal Weight No CO), AWNC (Abnormal Weight No CO), NWCO (Normal Weight CO), and AWCO (Abnormal Weight CO). Multinomial logistic regression models evaluated associations between DMOC groups and CMDs. Interaction analyses explored CO and CMD relationships across sex, BMI categories, and age groups. The mediation effect of CO indices on the relationship between BMI and cardiometabolic risk factors was investigated.ResultsBMI showed a slight to fair agreement with WHR and moderate agreement with WHtR. Individuals with AWCO had the highest odds for all CMDs (p<0.001). Males with NWCO had a 3.51 (2.14,6.04) times increased odds times for diabetes and 2.04 (1.22,3.37) times odds for dyslipidemia. Individuals < 58 years and males had stronger associations with CMDs.ConclusionCombining CO indices with BMI effectively identifies high-risk CMD groups in rural Indians, including those with NWCO a previously overlooked group.

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Evaluating a new obesity indicator for stroke risk prediction: comparative cohort analysis in rural settings of two nations

Yao,

Cui,

Shen

et al. 2024

BMC Public Health

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Background While the TyG index has been studied in relation to stroke risk, there is a lack of research integrating fat distribution indicators like Body Roundness Index (BRI) and Fat Mass Index (FMI). Additionally, comparative studies across multiple regions are scarce. This study investigates the association between obesity-related parameters and stroke incidence, examining the mediation effects of multimorbidity, using data from rural areas in China and the United Kingdom. Methods This cohort study included 60,685 participants (6,980 from China and 53,705 from UK). The obesity-related parameters were calculated using established formulas. The TyG index was determined as ln [TG (mg/dL) × GLU (mg/dL) / 2]. Additionally, composite indices were created by multiplying the TyG index by BMI, WC, FMI, and RBI to assess obesity-related risks. Cox regression analyses were employed on the relationship between Triglyceride Glucose index related parameters and stroke risk. Multiple mediation analysis was applied to assess the contributions of multimorbidity to obesity indicators in stroke occurrence. Results After excluding those who developed stroke within two years of enrollment, the Chinese cohort (6,638 subjects, median follow-up 4.33 years) had 237 ischemic and 21 hemorrhagic strokes. The UK cohort (53,631 subjects, median follow-up 13.85 years) had 742 ischemic and 316 hemorrhagic strokes. Chinese residents had lower BMI but higher visceral obesity (BRI), higher prevalence of multimorbidity, and higher stroke incidence compared to UK residents. Cox analyses demonstrated significant associations between BMI/TyG indices and ischemic stroke in both Chinese and UK populations, which diminished after adjusting for multimorbidity. In the Chinese rural cohort, only TyG-BRI (HR:1.13, 95%CI:0.99–1.30) approached statistical significance after full adjustment for mediators. In contrast, in the UK cohort, significant associations persisted for most TyG Index indicators when full adjustment for mediators, including BMI (HR: 1.17, 95% CI: 1.09–1.26), TyG-BMI (HR: 1.16, 95% CI: 1.07–1.26), TyG-WC (HR: 1.13, 95% CI: 1.03–1.25), TyG-FMI (HR: 1.17, 95% CI: 1.07–1.28), and TyG-RBI (HR: 1.15, 95% CI: 1.06–1.24). TyG-BRI also showed the best predictive performance for ischemic stroke in Chinese rural residents (AUC > 0.7) and exhibited an almost linear relationship with ischemic stroke occurrence. Additionally, TyG-BRI presented a U-shaped relationship with the risk of hemorrhagic stroke incidence in the UK ( p overall = 0.041, p non-linear = 0.017). Multimorbidity mediated the relationship between TyG indices, and ischemic stroke incidence in both cohorts. The mediation percentage for multimorbidity was higher than the sum of individual chronic diseases, with a higher mediation percentage in the Chinese cohort (up to 51%) compared to the UK cohort (up to 27.2%). ...

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Mechanisms of body fat distribution and gluteal-femoral fat protection against metabolic disorders

Cited by 6 publications

References 77 publications

Mechanisms by which obesity regulates inflammation and anti-tumor immunity in cancer

Mechanisms by which obesity regulates inflammation and anti-tumor immunity in cancer

Dual Metrics of Obesity: Evaluating BMI and Central Obesity as Indicators of Cardiometabolic Risk in Rural India

Evaluating a new obesity indicator for stroke risk prediction: comparative cohort analysis in rural settings of two nations

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