Research ArticleWrist circumference as a novel predictor of hypertension and cardiovascular disease: results of a decade follow up in a West Asian cohort
Introduction
Obesity and insulin resistance are chronic disorders both of which have increased in prevalence, especially in the Middle East region.1 Studies have linked these conditions and highlighted the possibility that bone metabolism might be integrated with multiple organs, including the adipose tissue network.2, 3 It is proposed that adiposity influences bone remodeling through different ways: (1) paracrine effect on adjacent skeletal cells or (2) cytokines production that directly could target the bone.4
Wrist circumference could be a good surrogate in order to analyze bone metabolism since it is easy to measure the skeletal frame without being severely confounded by body fat variation.5 Moreover, regional fat is increasingly recognized as detrimental of bone mineral density, an association that may be mediated by adipokines, such as adiponectin and leptin, and inflammatory fat products.6, 7 Chronic inflammation is deleterious to bone, and visceral adipose tissue predicts inflammatory markers.8
The associations between obesity and cardiovascular disease (CVD) events have been well established.9 Recently, number of studies have demonstrated a relationship between bone pathology and vascular disease such as CVD10 and hypertension.11 It has been suggested that there are common pathways that negatively affect bone metabolism and vascular disease.12 Recently, we demonstrated a significant association between wrist circumference and incident type 2 diabetes among women.13 In the current study, we aim to assess the association between wrist circumference, as a possible surrogate of bone status, and incident hypertension and CVD in a large community of healthy adult Iranian women.
Section snippets
Study Population
The Tehran Lipid and Glucose Study (TLGS) is an ongoing prospective study aimed at determining the risk factors and outcomes for non–communicable disease being conducted on a representative sample of 15,005 residents of district 13 of Tehran, aged 3 years and over.14 As designed in the TLGS protocol, the whole population was followed up in several phases, at about 3.6-year intervals. Of the 8397 female residents, 4536 subjects, aged ≥30 years, were examined in phase I TLGS (1999– 2001), and
Results
The present study was conducted in 3642 women aged 30 years and over. During a median 10 years of follow–up, 284 (6.3%) cases of new CVD and 615 (25.3%) cases of hypertension occurred. Comparison of baseline characteristics of study population showed that there were increasing trends in all CVD risk factors across wrist circumference tertiles except for smoking (Table 1). Also the incidence of CVD increased over 2-fold in the third tertile compared with the first tertile.
Table 2 shows the
Discussion
In a large community–based cohort of adult Middle Eastern women, we demonstrated that wrist circumference, as a possible surrogate of body–bone status independent of conventional risk factors of CVD, was associated with incident hypertension and incident CVD. However, when we considered fat distribution measures, the detrimental effects of increase in wrist circumference on hypertension and CVD was observed only among non–centrally obese women.
Epidemiologic studies have found strong association
Acknowledgments
The authors express appreciation to the participants of district 13, Tehran, for their enthusiastic support. We would also like to acknowledge Ms Nilufar Shiva for her critical editing of English grammar and syntax. This article is the result of Dr Reza Mohebi thesis.
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Exploring risk patterns for incident ischemic stroke during more than a decade of follow-up: A survival tree analysis
2017, Computer Methods and Programs in BiomedicineCitation Excerpt :Recently, the associations between wrist circumference and non-communicable disorders have been reported in a few studies; wrist circumference was positively and independently associated with pre-diabetes and type 2 diabetes in females of an Iranian population aged ≥20 years [19], and negatively associated with eGFR in an elderly Romanian population [20]. Also, wrist circumference was positively associated with risk of hypertension in non-centrally obese women aged ≥30 years [21]. In contrast, we recently demonstrated that in men aged ≥ 30 y, a wrist circumference of more than 17.75 cm was negatively associated with incident CVD, independent of conventional risk factors [22].
The value of wrist circumference for predicting the presence of coronary artery disease and metabolic syndrome
2016, Indian Heart JournalCitation Excerpt :Moreover, the role of such parameters is best considered in the context of other known risk factors as a whole rather than in parts. Some recent evidences have been focused on the usefulness of measuring WrC for predicting risk of CVDs.22,23 In fact, these evidences emphasize more on association between WrC and metabolic risk subgroups such as obesity, insulin resistance, and METs; and the independent role of WrC in predicting CAD risk has not been clearly determined.
There is no conflict of interest.