Diabetes & Metabolism Journal

Original Articles

Obesity and Metabolic Syndrome
Increased Risk of Progression of Coronary Artery Calcification in Male Subjects with High Baseline Waist-to-Height Ratio: The Kangbuk Samsung Health Study: Hyung-Geun Oh, Shriram Nallamshetty, Eun-Jung Rhee; Diabetes Metab J. 2016;40(1):54-61. Published online February 19, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.1.54

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Background

The waist-to-height ratio (WHtR) is an easy and inexpensive adiposity index that reflects central obesity. In this study, we examined the association of baseline WHtR and progression of coronary artery calcification (CAC) over 4 years of follow-up in apparently healthy Korean men.

Methods

A total of 1,048 male participants (mean age, 40.9 years) in a health-screening program in Kangbuk Samsung Hospital, Seoul, Korea who repeated a medical check-up in 2010 and 2014 were recruited. Baseline WHtR was calculated using the value for the waist in 2010 divided by the value for height in 2010. The CAC score (CACS) of each subject was measured by multi-detector computed tomography in both 2010 and 2014. Progression of CAC was defined as a CACS change over 4 years greater than 0.

Results

During the follow-up period, progression of CAC occurred in 278 subjects (26.5%). The subjects with CAC progression had slightly higher but significant baseline WHtR compared to those who did not show CAC progression (0.51±0.04 vs. 0.50±0.04, P<0.01). The proportion of subjects with CAC progression significantly increased as the baseline WHtR increased from the 1st quartile to 4th quartile groups (18.3%, 18.7%, 28.8%, and 34.2%; P<0.01). The risk for CAC progression was elevated with an odds ratio of 1.602 in the 4th quartile group of baseline WHtR even after adjustment for confounding variables (95% confidence interval, 1.040 to 2.466).

Conclusion

Increased baseline WHtR was associated with increased risk for CAC progression. WHtR might be a useful screening tool to identify individuals at high risk for subclinical atherosclerosis.

Citations

Citations to this article as recorded by

Nicotine dependence and visceral adiposity as risk factors for the development and severity of carotid artery stenosis
Mahmood Shaker Khazaal, Farqad Bader Hamdan, Qasim Sharhan Al-Mayah
Journal of Medicine and Life.2023; 16(3): 463. CrossRef
Differences in the number of stented coronary arteries based on the seven traditional obesity parameters among patients with coronary artery diseases undergoing cardiac catheterization
Audai A Hayajneh, Islam M Alhusban, Mohammad Rababa, Sami Al-Rawashdeh, Shatha Al-Sabbah, Dania Bani-Hamad
Electronic Journal of General Medicine.2022; 19(5): em391. CrossRef
Predictive Model for High Coronary Artery Calcium Score in Young Patients with Non-Dialysis Chronic Kidney Disease
Tae Ryom Oh, Su Hyun Song, Hong Sang Choi, Sang Heon Suh, Chang Seong Kim, Ji Yong Jung, Kyu Hun Choi, Kook-Hwan Oh, Seong Kwon Ma, Eun Hui Bae, Soo Wan Kim
Journal of Personalized Medicine.2021; 11(12): 1372. CrossRef
Computed tomography calcium scoring association and reclassification of clinical cardiovascular risk in asymptomatic Mexican patients
Aldo Javier Vázquez Mézquita, Michelle Claire Williams, Rafael Choza Chenhalls, Nancy Berenice Guzmán Martínez, Ana Patricia Chischistz Condey, Maria José Acosta Falomir, Marco Antonio Téliz Meneses, María Nayeli Vázquez Sánchez
SAGE Open Medicine.2020; 8: 205031212093823. CrossRef
The association of waist-to-height ratio and other anthropometric measurements with subclinical atherosclerosis: Results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
Rosana Raele, Paulo A. Lotufo, Marcio S. Bittencourt, Maria de Jesus M. Fonseca, Alessandra C. Goulart, Itamar S. Santos, Isabela M. Bensenor
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Jung-Hwan Cho, Eun-Jung Rhee, Se-Eun Park, Hyemi Kwon, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Hye Soon Park, Yang-Hyun Kim, Soon-Jib Yoo, Won-Young Lee
Diabetes & Metabolism Journal.2019; 43(2): 206. CrossRef
Being Metabolically Healthy, the Most Responsible Factor for Vascular Health
Eun-Jung Rhee
Diabetes & Metabolism Journal.2018; 42(1): 19. CrossRef
The renal tubular damage marker urinary N-acetyl-β-d-glucosaminidase may be more closely associated with early detection of atherosclerosis than the glomerular damage marker albuminuria in patients with type 2 diabetes
So Ra Kim, Yong-ho Lee, Sang-Guk Lee, Eun Seok Kang, Bong-Soo Cha, Byung-Wan Lee
Cardiovascular Diabetology.2017;[Epub] CrossRef
Influencia de la actividad física y el consumo calórico sobre la adiposidad visceral en adultos de la ciudad de Cuenca, Ecuador
Rina Ortiz, Maritza Torres, Wilson Siguencia, Nube Sigüenza-Cobos, Juan Salazar, Roberto Añez, Joselyn Rojas, Valmore Bermúdez
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Arsalan Salari, Maryam Shakiba, Marjan Mahdavi-Roshan, Mahboobeh Gholipour, Moona Naghshbandi, Ramin Rajabi
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Diet Quality and Mortality Risk in Metabolically Obese Normal-Weight Adults
Yong-Moon Mark Park, Teresa T. Fung, Susan E. Steck, Jiajia Zhang, Linda J. Hazlett, Kyungdo Han, Seung-Hwan Lee, Anwar T. Merchant
Mayo Clinic Proceedings.2016; 91(10): 1372. CrossRef
Waist Circumference as a Marker of Obesity Is More Predictive of Coronary Artery Calcification than Body Mass Index in Apparently Healthy Korean Adults: The Kangbuk Samsung Health Study
Jongsin Park, Eun Seo Lee, Da Young Lee, Jihyun Kim, Se Eun Park, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Eun-Jung Rhee
Endocrinology and Metabolism.2016; 31(4): 559. CrossRef

The Association of Unintentional Changes in Weight, Body Composition, and Homeostasis Model Assessment Index with Glycemic Progression in Non-Diabetic Healthy Subjects: Eun-Jung Rhee, Ji-Hun Choi, Seung-Hyun Yoo, Ji-Cheol Bae, Won-Jun Kim, Eun-Suk Choi, Se Eun Park, Cheol-Young Park, Seok Won Park, Ki-Won Oh, Sung-Woo Park, Sun-Woo Kim, Won-Young Lee; Diabetes Metab J. 2011;35(2):138-148. Published online April 30, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.2.138

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Abstract PDF PubReader

Background

We performed a retrospective longitudinal study on the effects of changes in weight, body composition, and homeostasis model assessment (HOMA) indices on glycemic progression in subjects without diabetes during a four-year follow-up period in a community cohort without intentional intervention.

Methods

From 28,440 non-diabetic subjects who participated in a medical check-up program in 2004, data on anthropometric and metabolic parameters were obtained after four years in 2008. Body composition analyses were performed with a bioelectrical impedance analyzer. Skeletal muscle index (SMI, %) was calculated with lean mass/weight×100. Subjects were divided into three groups according to weight change status in four years: weight loss (≤-5.0%), stable weight (-5.0 to 5.0%), weight gain (≥5.0%). Progressors were defined as the subjects who progressed to impaired fasting glucose or diabetes.

Results

Progressors showed worse baseline metabolic profiles compared with non-progressors. In logistic regression analyses, the increase in changes of HOMA-insulin resistance (HOMA-IR) in four years presented higher odds ratios for glycemic progression compared with other changes during that period. Among the components of body composition, a change in waist-hip ratio was the strongest predictor, and SMI change in four years was a significant negative predictor for glycemic progression. Changes in HOMA β-cell function in four years was a negative predictor for glycemic progression.

Conclusion

Increased interval changes in HOMA-IR, weight gain and waist-hip ratio was associated with glycemic progression during a four-year period without intentional intervention in non-diabetic Korean subjects.

Citations

Citations to this article as recorded by

Increased Risk of Nonalcoholic Fatty Liver Disease in Individuals with High Weight Variability
Inha Jung, Dae-Jeong Koo, Mi Yeon Lee, Sun Joon Moon, Hyemi Kwon, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
Endocrinology and Metabolism.2021; 36(4): 845. CrossRef
Effects of nutritional supplementation on glucose metabolism and insulin function among people with HIV initiating ART
Hiwot Amare, Mette F. Olsen, Henrik Friis, Pernille Kæstel, Åse B. Andersen, Alemseged Abdissa, Daniel Yilma, Tsinuel Girma, Daniel Faurholt-Jepsen
BMC Nutrition.2021;[Epub] CrossRef
The ratio of estimated average glucose to fasting plasma glucose level as an indicator of insulin resistance in young adult diabetes
Jun Guo, Sisi Lei, Yu Zhou, Congqing Pan
Medicine.2020; 99(40): e22337. CrossRef
Reduced Skeletal Muscle Volume and Increased Skeletal Muscle Fat Deposition Characterize Diabetes in Individuals after Pancreatitis: A Magnetic Resonance Imaging Study
Andre E. Modesto, Juyeon Ko, Charlotte E. Stuart, Sakina H. Bharmal, Jaelim Cho, Maxim S. Petrov
Diseases.2020; 8(3): 25. CrossRef
Insulin resistance increases the risk of incident type 2 diabetes mellitus in patients with non‐alcoholic fatty liver disease
Yuya Seko, Yoshio Sumida, Saiyu Tanaka, Kojiroh Mori, Hiroyoshi Taketani, Hiroshi Ishiba, Tasuku Hara, Akira Okajima, Atsushi Umemura, Taichiro Nishikawa, Kanji Yamaguchi, Michihisa Moriguchi, Kazuyuki Kanemasa, Kohichiroh Yasui, Shunsuke Imai, Keiji Shim
Hepatology Research.2018;[Epub] CrossRef
Use of Novel High-Protein Functional Food Products as Part of a Calorie-Restricted Diet to Reduce Insulin Resistance and Increase Lean Body Mass in Adults: A Randomized Controlled Trial
Carol Johnston, Barry Sears, Mary Perry, Jessica Knurick
Nutrients.2017; 9(11): 1182. CrossRef
Gender differences in the association between food insecurity and insulin resistance among U.S. adults: National Health and Nutrition Examination Survey, 2005–2010
Junxiu Liu, Yong-Moon Mark Park, Seth A. Berkowitz, Qingwei Hu, Kyungdo Han, Andrew Ortaglia, Robert E. McKeown, Angela D. Liese
Annals of Epidemiology.2015; 25(9): 643. CrossRef
1,5-Anhydroglucitol Is Associated with Early-Phase Insulin Secretion in Chinese Patients with Newly Diagnosed Type 2 Diabetes Mellitus
Xiaojing Ma, Yaping Hao, Xiang Hu, Yuqi Luo, Zixuan Deng, Jian Zhou, Yuqian Bao, Weiping Jia
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Serum glycated albumin as a new glycemic marker in pediatric diabetes
Ji Woo Lee, Hyung Jin Kim, Young Se Kwon, Yong Hoon Jun, Soon Ki Kim, Jong Weon Choi, Ji Eun Lee
Annals of Pediatric Endocrinology & Metabolism.2013; 18(4): 208. CrossRef
The Association of Maximum Body Weight on the Development of Type 2 Diabetes and Microvascular Complications: MAXWEL Study
Soo Lim, Kyoung Min Kim, Min Joo Kim, Se Joon Woo, Sung Hee Choi, Kyong Soo Park, Hak Chul Jang, James B. Meigs, Deborah J. Wexler, Noel Christopher Barengo
PLoS ONE.2013; 8(12): e80525. CrossRef
Relative contributions of insulin resistance and β‐cell dysfunction to the development of Type 2 diabetes in Koreans
C.‐H. Kim, H.‐K. Kim, E. H. Kim, S. J. Bae, J.‐Y. Park
Diabetic Medicine.2013; 30(9): 1075. CrossRef
Body Mass Index and Waist Circumference According to Glucose Tolerance Status in Korea: The 2005 Korean Health and Nutrition Examination Survey
Hye Mi Kang, Dong-Jun Kim
Journal of Korean Medical Science.2012; 27(5): 518. CrossRef
The Relationship between β-cell Function and Nutrient Intakes in Korean Adult - Using 4thKorea National Health and Nutrition Examination Survey 2009 -
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Korean Journal of Community Nutrition.2012; 17(2): 243. CrossRef
The ratio of glycated albumin to glycated haemoglobin correlates with insulin secretory function
Daham Kim, Kwang J. Kim, Ji H. Huh, Byung‐Wan Lee, Eun S. Kang, Bong S. Cha, Hyun C. Lee
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Cell Cycle Progression of Vascular Smooth Muscle cell Through Modulation of p38 MAPK and GSK-3beta Activities Under High Glucose Condition.: Yang Ho Kang, In Ju Kim, Yong Ki Kim, Seok Man Son; Korean Diabetes J. 2005;29(5):418-431. Published online September 1, 2005

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Abstract PDF: BACKGOUND: Macroangiopathy, with atherosclerosis, is the leading cause of mortality and morbidity in diabetic patients. Vascular smooth muscle cells play a crucial role in atherosclerosis, as they proliferate, migrate and express genes that encode inducible growth factors. However, the mechanisms induced by hyperglycemia that accelerate the proliferative change of vascular smooth muscle cells in diabetes remain unclear. This study was aimed at clarifying the respective roles of hyperglycemia in the acceleration of vascular complications in diabetes, examine the effects of hyperglycemia on vascular smooth muscle cell proliferation and the possible underlying mechanisms, including cell cycle progression. METHODS: Primary cultured rat aortic RASMs were exposed to normal glucose(5 mmol/L D-glucose), high glucose(30 mmol/L D-glucose) or an osmotic control (5mmol/L D-glucose plus 24.5 mmol/L mannitol) for 72 hours. The effect of high glucose on cell proliferation was determined by assessing the cell count and BrdU incorporation. Proteins involved in the cell proliferation pathway (PDK1, Akt/PKB, p42/44 MAPK, p38 MAPK, GSK-3beta) and those in cell cycle progression (cdk4, cyclin D, cdk2, cyclin E and ppRb phosphorylation) were determined by Western blot analysis. cdk4 kinase and PKC activity assays were also performed. RESULTS: A high level of glucose increased both the cell count(P<0.01) and BrdU incorporation(P<0.01). The PDK1, Akt/PKB and p42/44 MAPK activities were not significantly increased. A high level of glucose significantly increased the activities of p38 MAPK (P<0.01) and GSK-3beta(P<0.05) and the expressions of cdk4, cyclin D and ppRb phosphorylation. The cdk4 (P<0.01) and PKC (P<0.05) activities were also significantly increased. The inhibition of protein kinase C with GF109203X markedly reduced the phosphorylations of p38 MAPK and GSK-3betaand the expressions of cdk4 and cyclin D. In addition, pretreatment with GF109203X decreased the cell number in response to a high glucose level. CONCLUSION: These findings suggest that a high level of glucose increases vascular smooth muscle cell proliferation, with the possible mechanism further increases the G1 to S phase cell cycle progression via the activation of PKC, p38 MAPK and GSK-3beta.

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