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      Interactive Effect of Obesity Indexes on Cognition

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          This study aimed to investigate associations between obesity and poor cognitive performance using data from a community study of 467 individuals aged ≧65 years in South Korea. Cognitive function was ascertained using the Korean Mini-Mental State Examination (K-MMSE), and obesity using anthropometric measures including waist circumference and body mass index (BMI). Poor cognitive performance was present in 37% of the sample. General obesity (BMI ≧25) and poor cognition were strongly associated in the presence of abdominal obesity. Poor cognition was negatively associated with overweight (BMI 23–25) with normal waist circumference. Interaction terms with abdominal obesity for BMI increase were significant (p = 0.007). Obesity was associated with poor cognition, and obesity indexes must be carefully considered to reveal this relationship.

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          Most cited references 14

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          Early inflammation and dementia: a 25-year follow-up of the Honolulu-Asia Aging Study.

          Inflammatory responses are associated with cardiovascular disease and may be associated with dementing disease. We evaluated the long-term prospective association between dementia and high-sensitivity C-reactive protein, a nonspecific marker of inflammation. Data are from the cohort of Japanese American men who were seen in the second examination of the Honolulu Heart Program (1968-1970) and subsequently were reexamined 25 years later for dementia in the Honolulu-Asia Aging Study (1991-1996). In a random subsample of 1,050 Honolulu-Asia Aging Study cases and noncases, high-sensitivity C-reactive protein concentrations were measured from serum taken at the second examination; dementia was assessed in a clinical examination that included neuroimaging and neuropsychological testing and was evaluated using international criteria. Compared with men in the lowest quartile (<0.34mg/L) of high-sensitivity C-reactive protein, men in the upper three quartiles had a 3-fold significantly increased risk for all dementias combined, Alzheimer's disease, and vascular dementia. For vascular dementia, the risk increased with increasing quartile. These relations were independent of cardiovascular risk factors and disease. These data support the view that inflammatory markers may reflect not only peripheral disease, but also cerebral disease mechanisms related to dementia, and that these processes are measurable long before clinical symptoms appear.
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            The relation of body fat mass and distribution to markers of chronic inflammation.

            To study the relation of fibrinogen and C-reactive protein (CRP) to various measures of body fat and body fat distribution and to investigate whether these relations were explained by differences in insulin sensitivity. Cross-sectional analysis of the IRAS (Insulin Resistance Atherosclerosis Study), a large (n=1559) tri-ethnic population (non-Hispanic whites, African-Americans and Mexican-Americans) across different states of glucose tolerance. Glucose tolerance (oral glucose tolerance test), insulin sensitivity (frequently sampled intravenous glucose tolerance test and minimal model analysis), assessment of body fat mass and distribution (weight, girths, bioelectrical impedance), subclinical atherosclerosis (B-mode ultrasonography of carotid artery intima-media thickness, IMT), CRP (highly sensitive immunoassay), fibrinogen (standard assay). Both CRP and fibrinogen were related to all measures of body fat. Strong correlations (correlation coefficient r > or = 0.35) were found between CRP and body mass index (BMI), waist circumference and adipose body mass, respectively. The associations were consistent in non-diabetic and type-2 diabetic subjects, were generally stronger in women, and were only moderately attenuated by the prevailing insulin sensitivity (S(I)). In a multivariate linear regression model waist circumference explained 14.5% of the variability of circulating CRP levels (P=0.0001), BMI 0.4% (P=0.0067), and S(I) 1.7% (P=0.0001). Common carotid artery IMT was related to CRP and fibrinogen in men, but not in women, and was attenuated after adjusting for BMI or waist. Our findings show that measures of body fat are strongly associated with circulating levels of CRP and fibrinogen. These associations were not explained by lower S(I) in obese subjects. Chronic, subclinical inflammation may be one pathophysiological mechanism explaining the increased risk of atherosclerotic disease associated with adiposity.
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              A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys.

              To comparatively evaluate cut-off points of waist circumference, body mass index and waist to hip ratio with respect to their ability to predict other individual and multiple cardiovascular disease risk factors. Population-based, cross-sectional surveys. A total of 9913 men and women aged 18-74, selected using health insurance registries from five Canadian provinces. Anthropometric measures, other cardiovascular risk factors, receiver operating characteristic curves, sensitivity, specificity, positive and negative predictive values. : Waist circumference may be the best single indicator of other individual and multiple cardiovascular risk factors. Optimal cut-off points of all anthropometric measures are dependent on age, sex and the prevalence of the risk factor(s) being considered. For waist circumference, cut-off points of > or =90 cm in men and > or =80 cm in women may be most appropriate for prediction of individual and multiple risk factors in Caucasian populations. Health professionals should incorporate the use of waist circumference measurements in their routine clinical examination of adult patients.

                Author and article information

                Dement Geriatr Cogn Disord
                Dementia and Geriatric Cognitive Disorders
                S. Karger AG
                February 2005
                11 February 2005
                : 19
                : 2-3
                : 91-96
                aDepartment of Neurology, Chonbuk National University School of Medicine, Jeonju, bDepartment of Preventive Medicine, Seonam University School of Medicine, Namwon, cDepartment of Neurology, Sangmu Hospital, and dDepartment of Neurology, Chonnam University School of Medicine, Gwangju, Republic of Korea
                82659 Dement Geriatr Cogn Disord 2005;19:91–96
                © 2005 S. Karger AG, Basel

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                Page count
                Tables: 3, References: 37, Pages: 6
                Original Research Article


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