Sangmo Hong

Scaling of adult body weight to height across sex and race/ethnic groups: relevance to BMI

BACKGROUND Body mass index (BMI) is formulated on the assumption that body weight (BW) scales to height with a power of 2 (BW∝height(2)), independent of sex and race-ethnicity. Powers differing from 2 are observed in studies of selected samples, thus raising the question if BMI is a generalizable metric that makes BW independent of height across populations. OBJECTIVES The objectives were to test the hypothesis that adult BW scales to height with a power of 2 independent of sex and race-ethnicity and to advance an understanding of BMI as a measure of shape by extending allometric analyses to waist circumference (WC). DESIGN We conducted cross-sectional subject evaluations, including body composition, from the NHANES and the Korean NHANES (KNHANES). Variations of the allometric model (Y = αX(β)) were used to establish height scaling powers (β ± SE) across non-Hispanic white and black, Mexican American, and Korean men and women. RESULTS Exploratory analyses in population samples established age and adiposity as important independent determinants of height scaling powers (i.e., β). After age and adiposity in the next series of analyses were controlled for, BW scaling powers were nonsignificantly different between race/ethnic groups within each sex group; WC findings were similar in women, whereas small but significant between-race differences were observed in the men. Sex differences in β values were nonsignificant except for BW in non-Hispanic blacks and WC in Koreans (P < 0.05). Nationally representative powers for BW were (NHANES/KNHANES) 2.12 ± 0.05/2.11 ± 0.06 for men and 2.02 ± 0.04/1.99 ± 0.06 for women and for WC were 0.66 ± 0.03/0.67 ± 0.05 for men and 0.61 ± 0.04/0.56 ± 0.05 for women. CONCLUSIONS Adult BW scales to height with a power of ∼2 across the 8 sex and race/ethnic groups, an observation that makes BMI a generalizable height-independent measure of shape across most populations. WC also follows generalizable scaling rules, a finding that has implications for defining body shape in populations who differ in stature.

The Relationship Between Coronary Artery Calcification and Bone Mineral Density in Patients According to Their Metabolic Syndrome Status

Background and Objectives The extent of coronary artery calcification (CAC) is closely related to total atherosclerotic plaque burden. However, the pathogenesis of CAC is still unclear. Conditions such as diabetes mellitus, renal failure, smoking, and chronic inflammation have been suggested to link vascular calcification and bone loss. In the present study, we hypothesized that bone loss can contribute to the pathogenesis of CAC in patients with the chronic inflammatory condition that accompanies metabolic syndrome (MetS). The objective of this study was to investigate the relationship between CAC and bone mineral density (BMD) in patients with MetS and in patients without MetS, by using coronary multidetector-row computed tomography (MDCT). Subjects and Methods Data from 395 consecutive patients was analyzed retrospectively. From the MDCT database, only those patients who underwent both coronary MDCT and dual-energy X-ray absorptiometry within an interval of one month, were selected. The presence of MetS was determined by the updated criteria as defined by the Third Adult Treatment Panel Report of the National Cholesterol Education Program. Results In patients with MetS, a significant correlation was found between CAC and age {odds ratio (OR)=1.139, 95% confidence interval (CI) 1.080 to 1.201, p<0.001}, CAC and male sex (OR=3.762, 95% CI 1.339 to 10.569, p=0.012), and CAC and T-score of L-spine (OR=0.740, 95% CI 0.550 to 0.996, p=0.047) using a forward multiple logistic regression analysis model including clinical variables of gender, age, lipid profile, body mass index, diabetes mellitus, hypertension, smoking, and BMD. But in patients without MetS, BMD by itself was not found to contribute to CAC. Conclusion BMD was inversely correlated with CAC only in patients with MetS. This finding suggests that low BMD accompanied by MetS, may have significant clinical implications.

Scaling of adult regional body mass and body composition as a whole to height: Relevance to body shape and body mass index

Adult body mass (MB) empirically scales as height (Ht) squared (MB ∝ Ht2), but does regional body mass and body composition as a whole also scale as Ht2? This question is relevant to a wide range of biological topics, including interpretation of body mass index (BMI).

Clinical characteristics of relapses and re-infections in Clostridium difficile infection.

The purpose of this study was to identify factors associated with relapses or re-infections in patients with recurring Clostridium difficile infections (CDIs). From September 2008 to January 2012, cases with two or more isolates from consecutive CDI episodes were included. PCR-ribotyping and multilocus variable-number tandem-repeat analysis were performed using paired isolates. Among 473 patients, 68 (14.4%) experienced one to five recurrences. Fifty-one of these with two or more isolates from consecutive CDI episodes were included in the study; 25 (49%) were classified as relapses and 26 (51%) as re-infections. Recurrence interval was shorter in the relapse group (26.0 versus 67.5 p 0.001), but more patients in the re-infection group were hospitalized during recurrence interval (53.8% versus 8.0%, p<0.001). Relapse rates in infections by ribotype 017, ribotype 018 and other ribotypes were 63.6%, 63.6% and 22.2%, respectively (p 0.274, p 0.069, and p 0.005). In multivariate logistic regression, infections by ribotypes 017 and 018 were associated with CDI relapse (OR 4.77, 95% CI 1.02-22.31, p 0.047; OR 11.49, 95% CI 2.07-63.72, p 0.005). Conversely, admission during recurrence interval lowered the risk of relapse (OR 0.044, 95% CI 0.006-0.344, p 0.003). In conclusion, relapse was more likely when infection was caused by PCR ribotypes 017 and 018.

The effects of sarcopenia and obesity on femur neck bone mineral density in elderly Korean men and women

Objectives We aimed to clarify the relationship between fat, muscle, and bone in elderly men and women. Methods We analyzed 1373 men and 1803 women who were older than 65 years from the 2008–2010 Korea National Health and Nutritional Examination Surveys. Body composition and femur neck bone mineral density (BMD) were measured by dual-energy X-ray absorptiometry. Sarcopenia was defined as an appendicular skeletal muscle index (SMI) below one standard deviation (SD). Obesity was classified by fat mass index (FMI). Osteoporosis was defined as a BMD of 2.5 SD below that of femur neck BMD. Results SMI and FMI were positively correlated with femur neck BMD. In multiple regression analysis, SMI (β = 0.302 in men, β = 0.154 in women; p < 0.001 each) and FMI (β = 0.079 in men, β = 0.179 in women; p = 0.003 and p < 0.001 respectively) had a positive relationship with femur neck BMD. Men with sarcopenia were 3.89 times more likely to develop osteoporosis. Women with sarcopenia were 1.87 times more likely to develop osteoporosis. Sarcopenia was more clinically significant in the development of osteoporosis in men with a fat deficit and women with excess fat. Conclusions Muscle mass and fat mass were identified as determinants of femur neck BMD in men and women. Among them, muscle mass of men and fat mass of women are the most important determinants of femur neck osteoporosis.