The obesity prevalence and its interrelations with cardiovascular risk in Mongolian urban employed population
Author Affiliations1Irkutsk State Medical Academy of Postgraduate Education of Minzdrav of Russia 664049, Irkutsk, Yubileiny district, 100
2Ulaanbaatar Railway Hospital 210535, P. Zhasray str., 6, Ulaanbaatar, Mongolia
Abstract
Purpose: to study the prevalence of obesity and identify its markers closely related with cardiovascular risk increase among urban employed Mongolians. Methods. The anthropometry and body bioimpedance analysis were carried out in 1277 railway workers aged 18-63. Blood pressure, lipids and fasting plasma glucose levels were measured. 10-year risk for cardiovascular events was calculated. Results. The prevalence of general obesity was 65.4 % in men and 68.5 % in women. Abdominal obesity was found in 58.5 % of men and 76.1 % of women. The 10-year risk for cardiovascular events by the SCORE (Systematic Coronary Risk Evaluation), FHS (Framingham Heart Study) and ASCVD (Atherosclerotic Cardiovascular Disease risk) algorithms were assessed as well as proportions of men and women at elevated/high cardiovascular risk were determined. The obesity-related markers with the best diagnostic accuracy for elevated/high cardiovascular risk were revealed by ROC-analysis. For men they were waist circumference waist-to-height ratio, for women - the body fat percentage. The optimal cutoff values for these predictors and corresponding odds ratios for risk increase were determined.
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References1. Kokren U. Methods of sampling research. Moscow, 1976. 89 p. (in Russian)
2. Martirosov E.G., Nikolaev D.V., Rudnev S.G. Technologies and methods of human body composition evaluation. Moscow: Nauka. 2006. 248 p. (in Russian)
3. Osipova I.V., Antropova O.N., Vorobyeva E.N., Simonova G.I. Total cardiovascular risk assessment in people with high stress occupation // Kardiovaskulyarnaya terapiya i profilaktika. 2008. 7. (6). 33-37. (in Russian)
4. Осипова И.В., Симонова Г.И., Калинина И.В. и др. Сравнительная оценка значимости кардиометаболических факторов риска у работников стрессовых профессий // Кардиоваскулярная терапия и профилактика. 2012. 11. (3). 53-57. (in Russian)
5. B.Oungerel, G.Otgon, Narjaa et. al. Body composition analysis in Mongolians // Sibirskiy meditsinskiy zhurnal. 2011. (7). 106-108. (in Russian)
6. Протасов К.В., Мягмарсурен Т. Распространенность метаболического синдрома среди работников железнодорожного транспорта Монголии // Сиб. мед. журн. 2013. 116. (1). 43-47. (in Russian)
7. Shalnova S.A., Deev A.D., Oganov R.G. Factors influencing cardiovascular mortality in Russian population // Kardiovaskulyarnaya terapiya i profilaktika. 2005. 4. (1). 4-9. (in Russian)
8. Batsis J.A., Singh S., Lopez-Jimenez F. Anthropometric measurements and survival in older americans: results from the third national health and nutrition examination survey // J. Nutr. Health Aging. 2014. 18. (2). 123-130.
9. Bioelectrical impedance analysis in body composition measurement: National Institute of Health Technology. Assessment Conference Statement // Am. J. Clin. Nutr. 1996. 64. (Suppl. 3). 524S-532S.
10. Browning L.M., Hsieh S.D., Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value // Nutr. Res. Rev. 2010. 23. (2). 247-269.
11. Czernichow S., Kengne A.P., Stamatakis E. et al. Body mass index, waist circumference and waist-hip ratio: which is the better discriminator of cardiovascular disease mortality risk?: Evidence from an individual-participant meta-analysis of 82 864 participants from nine cohort studies // Obes. Rev. 2011. 12. (9). 680-687.
12. D'Agostino R.B., Vasan R.S., Pencina M.J. et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study // Circulation. 2008. 117. (6). 743-753.
13. Dugee O., Khor G.L., Lye M.S. et al. Association of major dietary patterns with obesity risk among Mongolian men and women // Asia Pac. J. Clin. Nutr. 2009. 18 (3). 433-440.
14. Fawcett T. An introduction to ROC analysis // Pattern Recognit. Lett. 2006. 27. 861-874.
15. Goff D.C. Jr., Lloyd-Jones D.M., Bennett G. et al. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines // J. Am. Coll. Cardiol. 2013. pii: S0735-1097(13)06031-2. doi: 10.1016/j.jacc.2013.11.005.
16. Hill J.O., Peters J.C. Environmental contributions to the obesity epidemic // Science. 1998. 280. 1371-1374.
17. Hubert H.B., Feinleib M., McNamara P.T. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants of the Framingham Heart Study // Circulation. 1983. 67. 968-977.
18. Human development report Mongolia 2000. Reorienting the state. Ulaanbaatar, 2000. 31 p.
19. Li G., de Courten M., Jiao S., Wang Y. Prevalence and characteristics of the metabolic syndrome among adults in Beijing, China // Asia Pac. J. Clin. Nutr. 2010. 19. (1). 98-102
20. Otgontuya D. Jr., Khor G.L., Lye M.S., Norhaizan M.E. Obesity among Mongolian Adults from Urban and Rural Areas // Malays. J. Nutr. 2009. 15. (2). 185-194.
21. Parale G.P., Patil V.C., Patil S.P. et al. Metabolic syndrome in railway employees and its relation to lifestyle factors // Metab. Syndr. Relat. Disord. 2008. 6. 58-63.
22. Peng H., Jiao Y., Zeng Q. et al. Utility of Framingham general cardiovascular disease risk score for predicting 10-year cardiovascular risk in an inner Mongolian population: A prospective cohort study // Int. J. Cardiol. 2014. 172. (1). 274-275.
23. Perk J., De Backer G., Gohlke H. et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) // Eur. Heart J. 2012. 33. (13). 1635-701.
24. Shiwaku K., Nogi A., Kitajima K. et al. Prevalence of the metabolic syndrome using the modified ATP III definitions for workers in Japan, Korea and Mongolia // J. Occup. Health. 2005. 47. 126-135.
25. Shiwaku K., Anuurad E., Enkhmaa B. et. al. Overweight Japanese with body mass indexes of 23.0-24.9 have higher risks for obesity-associated disorders: a comparison of Japanese and Mongolians // Int. J. Obes. Relat. Metab. Disord. 2004. 28. (1). 152-158.
26. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies // Lancet. 2004. 363. (9403). 157-163.
27. WHO. Global Health Risks: mortality and burden of disease attributable to selected major risks. World Health Organization, 2009. 62 p.
28. WHO/IASO/IOTF. The Asia Pacific Perspective: Redefining Obesity and its treatment, Health Communications Australia Pty Ltd. 2000. 55 p.
29. Wulan S.N., Westerterp K.R., Plasqui G. Ethnic differences in body composition and the associated metabolic profile: a comparative study between Asians and Caucasians // Maturitas. 2010. 65. (4). 315-319.
30. Zimmet P.Z., Alberti K.G. Introduction: Globalization and the non-communicable disease epidemic // Obesity (Silver Spring). 2006. 14. (1). 1-3.
About Authors (Correspondence):
Protasov K.V. - doctor of medical sciences, pro-rector for research, professor of internal diseases and cardiology chair, e-mail: protassov_k@rambler.ru
Myagmarsuren Tarvaa - head of internal diseases department, postgraduate student of internal diseases and cardiology chair, е-mail: migatrv@yahoo.com
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