Faculty of Medicine
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Item type:Publication, Indicators of abdominal obesity: waist circumference and waist-to-hip ratio in adolescence of North Macedonia(Macedonian Association of Anatomists, 2021-04-02); ; ; ; Obesity in children and adolescents in the world is reaching a scale of an epidemic. It is considered the most widespread disease in children in many countries, especially in developed countries. The aim of this study was to define WC and WHR among Macedonian adolescents aged 11 to 14 years. A cross-sectional study was performed in 2013-2015, comprising a sample of 1267 adolescents of the Republic of Macedonia aged 11 to 14 years; 646 males and 621 females. Weight, height, body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR) were measured and percentiles were calculated using Cole’s Lambda, Mu and Sigma (LMS) method. The relation between WHR and general obesity, as defined by the International Obesity Task Force, was investigated with receiver operating characteristic (ROC) analysis. The boys had statistically significant higher values in all anthropometric measures, except in HC where statistically significant gender differences were not found. BMI, WC, and HC increased with the age. The obtained reference percentile curves can be used temporarily for obesity screening in children and adolescents. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DIAGNOSTIC CENTRAL OBESITY INDEXES CUT – OFF POINT VALUES DETERMINED WITH DUAL-ENERGY X-RAY ABSORPTIOMETRY IN CUSHING’S AND OBESE WOMEN(Macedonian Academy of Sciences and Arts, 2020); ; ; Aim: The aim of this study was to develop quantiative criteria for defining visceral obesity and to establish dual-energy X-ray absorptiometric (DXA) diagnostic cut-off points (CP) for normal and abnormal values of the central obesity indexes (COI) that best differentiate extreme visceral obesity in Cushing’s syndrome (CS) from non CS obese and non obese women. Material and Methods: COI1–4 values calculated as a ratio of android to gynoid tissue mass, fat mass and their % were determined in 4 groups, each consisting of 18 women: 1st group of CS, 2nd group of obese women (O1 ) not different according to their age and BMI from CS, 3rd group of obese women (O2 ) with BMI of 35 ± 1.2 kg and 4th group of non obese healthy women (C) with normal BMI. Diagnostic accuracy (DG) of CP values of COI1m-4m indexes of abdominal obesity and CP values of COI1n-4n indexes of normal body fat distribution (BFD) was determined. Results: COI1-4 indexes values were highly significantly different among the 4 examined groups and were significantly highest in CS patients and lowest in group C (p < 0.0001). COI1m-4m CP values differentiated extreme visceral, abdominal obesity in CS with highest DG as well as COI1n-4n CP values differentiated normal BFD in group C. COI1m CP of 0.55 best differentiated CS from O1 for DG of 100%. COI2n of 0.38 best differentiated C from CS and O2 for highest DG of 100% compared to O1 because of the significantly higher BMI and COI1n-4n values in O2 that were associated with more pronounced abdominal obesity and highly significantly positive correlation with BMI. Conclusions: DXA cut-off point values of indexes COI1m-4m and COI1n-4n were established as diagnostic indexes and criteria useful in discovering extreme abdominal and normal BFD. COI1m CP value of 0.55 was discovered as a diagnostic criterion of extreme abdominal obesity and COI2n of 0.38 as a diagnostic criterion of normal BFD that excluded abdominal obesity. The other indexes COI1m-4m and COI1n-4n CP values had also high DG in discovering abdominal and normal body fat distribution. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, BODY FAT DISTRIBUTION CHANGES DURING WEIGHT LOSS DETERMINED BY DUAL-ENERGY X-RAY ABSORPTIOMETRIC TRUNK/ TOTAL RATIOS AS INDEXES OF ABDOMINAL OBESITY(SHMSHM / AAMD, 2019); ; Objective. The effect of weight loss on body fat distribution was examined through the trunk/total tissue and fat mass ratios, indexes of central, abdominal obesity determined by dual-energy X-ray absorptiometry (DXA). Material and methods. Following parameters were determined before and after weight loss: body mass index (BMI), body weight (BW), total and trunk fat mass (FM) and its percent (FM%), tissue mass (TM) and TM fat percent (TMf%) with DXA as well as DXA indexes of abdominal body fat distribution: trunk/total FM (Tr/To FM) and Tr/To FM%, trunk/total TM (Tr/To TM) and trunk/total TMf% (Tr/To TMf%) in two overweight subjects. Results. BW of 62.9±1.2 kg and BMI value of 28.98±0.78 kg/m2 before the weight loss lowered to 49.96±1.3 kg (p<0.012) and normal BMI 22.81±0.62 kg/m2 (p<0.012). Tr/To TMf% value decrease from 1.02±0.01 to 0.97±0.03 was significant (p<0.013) and Tr/To FM% value decrease from 1.04±0.01 to 0.99±0.02 was also significant (p<0.01). Tr/ To TM value decreased significantly from 0.55±0.02 to normal value 0.48±0.02 (p<0.019). Tr/To FM index value decreased significantly from 0.56±0.02 to normal value 0.48±0.03 (p<0.033). Tr/To TM and Tr/To FM after weight loss reached normal values. Conclusions. It was confirmed that DXA indexes of central, abdominal obesity Tr/To TM and Tr/To FM were increased in overweight subjects before the weight loss and lowered significantly after the weight loss to normal values, indicating that normal BMI and BW reached after the weight loss were associated with normalized body fat distribution - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DIAGNOSING ABDOMINAL OBESITY IN WOMEN WITH CUT – OFF POINT VALUES OF THE ESTIMATED CENTRAL OBESITY INDEX DETERMINED WITH DUAL-ENERGY X-RAY ABSORPTIOMETRY(Macedonian Association of Anatomists and Morphologists, 2020); ; Introduction: Dual-energy X-ray absorptiometric (DXA), central obesity index (COI) and estimated COI (eCOI) are useful diagnostic DXA test procedures of extreme central, abdominal obesity in Cushing’s syndrome (CS) and non CS abdominally obese women, and determination of their diagnostic cut-off point values (CPV) is very important. Materials and methods: COI and eCOI values were determined in 3 groups, each consisting of 18 women: 1st group of CS, 2nd group of obese women (O) not different according to their age and Body Mass Index (BMI) with CS and 3rd group of non-obese healthy women (C) with normal BMI. COI1 and eCOI1 CPV were used to best differentiate CS and O. COI2 and eCOI2 CPV were used to best differentiate CS and O with C. Their diagnostic accuracy (DG), sensitivity (S) and specificity (SP) were determined. Results: COI and eCOI values were significantly different among the 3 groups. COI1 CPV of 0.9 best differentiated CS from O with DG of 70% and sensitivity of 90% but eCOI1 CPV of 0.92 differentiated them with DG of 75% and S of 100%. COI2 CPV of 0.82 best differentiated C from O with DG of 82.14% and SP of 88.89% as well as eCOI2 CPV of 0.84 differentiated them for DG of 75% and SP of 80%. COI2 CPV of 0.82 and eCOI2 0.84 best differentiated CS from C in both cases for DG of 92.86% and SP of 88.89%. Conclusion: Cut-off point values of COI1 and COI2 as well as eCOI1 and eCOI2 are very important diagnostic test procedures in discovering abdominal and normal body fat distribution. Determined eCOI1 and eCOI2 cut-off point values are especially very useful diagnostic screening tests of body fat distribution in everyday routine clinical praxis during spine and hip bone mineral content assessment. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Total/Legs Dual-Energy X-Ray Absorptiometric Index In Differentiation Of Normal Body Fat Distribution In Healthy Women From Cushing’s And Non Cushing Obese(2020); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Trunk/Legs Dual Energy X-Ray Absorptiometric Index Of Abdominal Obesity In Diagnosing Visceral Obesity In Cushing’s And Obese Women(2020); ; ; Maja DimitrovskaObjectives: Obesity and especially central body fat distribution (BFD) are known risk factors for cardiovascular and metabolic diseases. Android obesity in Cushing’s syndrome (CS) and in non CS abdominally obese women with the metabolic syndrome, which is predominantly visceral, intra-abdominal, is more predictive of adipose-related comorbidities than gynecoid obesity, which has a relatively peripheral (gluteal) distribution. Determination of dual-energy x-ray absorptiometric (DXA) indexes cut-off point values of abdominal obesity is very important to discover obese women with abdominal obesity. The aim of this study was to determine cut-off point values of DXA indexes of central, abdominal obesity determined as a ratio of trunk to legs tissue and fat mass and their percentages that best differentiate CS and O and confirm central, abdominal obesity. Material and Methods: DXA assessment of body composition and BFD was performed in two groups of women, each consisting of 21 subjects: 1st group of CS with clinically confirmed CS with Body Mass Index (BMI) (30.03±6.49 kg/m2 ) and age of 42.98±13.27 years and 2nd group of obese women (O), matched with CS according to their BMI (29.91±6.12 kg/m2 ) and age (41.04±12.85 years). Trunk/Legs tissue mass ratio (Tr/L-T), trunk/legs fat mass ratio (Tr/L-F), trunk/legs tissue % fat mass ratio (Tr/L-T%f) and trunk/legs fat mass % ratio (Tr/L-F%) were determined as indexes of central, ab - dominal obesity and their cut-off point values that best differentiate CS women from O were also determined. Sensitivity (S), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and DG (diagnostic accuracy) of these idexes were determined. Results: Tr/L-T values in CS were 2.05±0.44, significantly higher compared to 1.42±0.28 in O, and Tr/L-F values in CS 2.33±0.55 were also significantly higher compared to O (1.39±0.66) (p<0.0001). Tr/L-T%f values in CS were 1.15±0.14, significantly higher compared to 0.94±0.22 in O, as well as Tr/L-F% values of 1.18±0.12 in CS were significantly higher compared to O (0.94±0.68) (p<0.0001). Tr/L-T cut-off point value of 1.6 best differentiated CS from O for DG of 88.89% and Tr/L-F cut-off point value of 1.8 best differentiated CS from O for DG of 88.89%. Tr/L-T%f value of 1.0 differentiated CS from O for DG of 72.22% and Tr/L-F % value of 1.1 differentiated CS and O for DG of 77.78%. Tr/L-T and Tr/L-F differentiated CS and O with higher diagnostic accuracy. Tr/L-T with higher sensitivity of 94.44% and NPV value of 93.75% differentiated CS from O compared to the Tr/L-F correspondent values 83.33% and 85%. Conclusion: Tr/L-T and Tr/L-F DXA indexes cut-off point values of 1.6 and 1.8 best differentiated CS women from matched O women with high diagnostic accuracy. They confirmed abdominal, visceral obesity in CS with significantly higher values in CS compared to obese women and could be used as diagnostic indexes of abdominal obesity. Tr/L-T%f and Tr/L-F% indexes differeniated the two examined groups with lower diagnostic accuracy and are not useful in diagnosing abdominal obesity. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Comparison Of Trunk/Legs To Trunk/Total Dual-Energy X-Ray Absorptiometric Indexes Of Abdominal Obesity In Differentiation Of Cushing’s And Obese Women(2020); ; ; Slagjana MaksimoskaObjectives: Patients with Cushing’s syndrome (CS) are obese or overweight, and have abdominal, visceral adiposity. Accurate quantitative assessment of the visceral adiposity is essential in the evaluation of potential risk for the development of serious medical illnesses. Dual-energy X-ray absorptiometry (DXA) method is the gold standard for assessment of bone health and body composition that provides accurate, comprehensive, precise measurements of total and regional body fat distribution. Determination of DXA indexes cut-off point values of abdominal obesity is very important to discover obese women with abdominal obesity. Material and Methods: DXA assessment of body composition and body fat distribution was performed in two groups of women, each consisting of 21 subjects: 1st group of Cushing’s syndrome with clinically confirmed CS with Body Mass Index (BMI) (30.03±6.49 kg/m2) and age of 42.98±13.27 years and 2nd group of obese women (O), matched with CS according to their BMI (29.91±6.12 kg/m2) and age (41.04±12.85 years). Trunk tissue mass (Tr-T) and trunk fat mass (Tr-F) and their percentages values, trunk tissue percent fat (Tr-T%f) and trunk fat percent (Tr-F%) were determined. Legs and total tissue mass (L-T; To-T) and legs and total fat mass (L-F; To-F) and their percentages (L-T%f; To-T%f) and (L-F%; To-F%) were determined also. Their ratios Tr/L-T and Tr/To-T, Tr/L-F and Tr/To-F, Tr/L-T%f and Tr/To-T%f, Tr/L-F% and Tr/To-F % were determined as indexes of central, abdominal obesity and their cut-off point values that best differentiate CS women from O were determined. Sensitivity (S), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and DG (diagnostic accuracy) of these idexes were determined. Results: Tr/L-T and Tr/To-T values in CS were significantly higher compared to O as well as Tr/L-F and Tr/To-F values in CS were also significantly higher compared to O (p<0.0001). Tr/L-T%f and Tr/To-T%f values in CS as well as Tr/L-F% and Tr/To-F% values in CS were significantly higher compared to O (p<0.0001). Tr/To-T cut-off point value of 0.52 and Tr/L-T cut-off point value of 1.6 best differentiated CS from O for DG of 88.89%. Tr/To-F cut-off point value of 0.53 and Tr/L-F of 1.8 best differentiated CS from O for DG of 83.33% and 88.89%. Tr/To-T%F and Tr/L-T%f best differentiated CS from O for DG of 69.44% and 72.22% respectively. Tr/To-F% and Tr/L-F% best differentiated CS from O for DG of 72.22% and 77.78%. Tr/To-T, Tr/L-T, Tr/T-F and Tr/L-F differentiated CS and O with higher diagnostic accuracy compared to their percentage values. Conclusion: All examined indexes confirmed abdominal, visceral obesity in CS with significantly higher values in CS compared to matched obese women. Tr/To-T and Tr/L-T as well as Tr/To-F and Tr/L-F indexes differentiated CS from obese women with very similar diagnostic accuracy. Percentage ratios of the DXA indexes differentiated the two examined groups with lower diagnostic accuracy and are not useful in diagnosing the abdominal obesity.