The incidence of nonalcoholic fatty liver disease(NAFLD) is increasing worldwide, and it is strongly associated with metabolic syndrome (MetS) and some obesity-related indices. However, few studies have investigated gender differences in these associations. The aim of this study was to investigate associations among MetS and various obesity-related indices with NAFLD, and also look at gender differences in these associations. We enrolled participants who completed a health survey in southern Taiwan. MetS was defined according to the Adult Treatment Panel III for Asians, and the following obesity-related indices were calculated: body mass index (BMI), waist-to-height ratio (WHtR), waist–hip ratio (WHR), lipid accumulation product (LAP), body roundness index (BRI), conicity index (CI), visceral adiposity index (VAI), body adiposity index (BAI), abdominal volume index (AVI), triglyceride-glucose (TyG) index, and hepatic steatosis index (HSI). NAFLD was diagnosed when hepatic steatosis was noted on a liver ultrasound. A total of 1969 (764 men and 1205 women) participants were enrolled. Multivariable analysis showed that both male and female participants with MetS, high BMI, high WHtR, high WHR, high LAP, high BRI, high CI, high VAI, high BAI, high AVI, high TyG index, and high HSI were significantly associated with NAFLD. In addition, the interactions between MetS and gender, WHR and gender, LAP and gender, and TyG index and gender on NAFLD were statistically significant. Among these obesity-related indices, HSI and LAP had the greatest area under the curve in both men and women. Furthermore, stepwise increases in the number of MetS components and the values of indices corresponding to the severity of NAFLD were noted. In conclusion, our results demonstrated significant relationships between MetS and obesity-related indices with NAFLD, and also stepwise increases in the number of MetS components and the values of indices with the severity of NAFLD. MetS, WHR, LAP, and TyG index were associated with NAFLD more obviously in women than in men.

The prevalence and incidence rates of kidney stone disease (KSD) in Taiwan are high; however, the association between lipid profile and KSD has yet to be investigated. The aim of this longitudinal study was to investigate the association between lipid profile with baseline and incident KSD in a large Taiwanese cohort. A total of 27,002 people enrolled in the Taiwan Biobank (TWB) were followed for a median of 4 years and classified into two groups according to whether they had (n = 1813; 6.7%) or did not have (n = 25,189; 93.3%) KSD at baseline. The presence of KSD was defined according to a self-reported history of kidney stones. The participants with baseline KSD (n = 1813) were excluded from the follow-up study, and the remaining participants were classified into two groups consisting of those who had (n = 640; 2.5%) or did not have (n = 24,549; 97.5%) incident KSD. After multivariable analysis, compared to quartile 1 of lipid profile, the participants in quartile 4 of triglycerides, quartiles 3 and 4 of high-density lipoprotein cholesterol (HDL-C), and quartile 4 of total cholesterol (Chol)/HDL-C ratio were significantly associated with baseline KSD. In the follow-up study, the participants in quartiles 2, 3, and 4 of triglycerides; quartile 2 of Chol; quartile 4 of HDL-C; quartile 3 of LDL-C; and quartiles 3 and 4 of Chol/HDL-C ratio were significantly associated with incident KSD. Our results showed that hypertriglyceridemia (67–93 mg/dL) was associated with a 1.463-fold increased risk of incident KSD and that low HDL-C (>63 mg/dL) protected against incident KSD formation. In addition, a Chol/HDL-C ratio larger than 3.64 was associated with a 1.381-fold increased risk of incident KSD. Our findings may imply that the optimal management of dyslipidemia may be associated with a lower risk of developing kidney stones.

Metabolic syndrome (MetS) is prevalent in Taiwan; however, the association between MetS and cognitive function is unclear. The aim of this study was to explore the associations between MetS, its components, and obesity-related indices with cognitive function in a large Taiwanese cohort. We enrolled a total of 28,486 participants who completed the Mini-Mental State Examination (MMSE) questionnaire, which was used to evaluate cognitive function. MetS was defined according to the NCEP-ATP III guidelines and modified criteria for Asians. Ten obesity-related indices were also evaluated: body mass index (BMI), abdominal volume index (AVI), body adiposity index (BAI), waist–hip ratio (WHR), a body shape index (ABSI), lipid accumulation product, waist-to-height ratio (WHtR), conicity index (CI), body roundness index (BRI), and triglyceride glucose index. The prevalence of MetS and its components (except for hypertriglyceridemia) and the number of MetS components increased while the cognitive impairment worsened (from MMSE ≥ 24, 18–23 to 0–17). In addition, increases in all obesity-related index values were associated with a decline in cognitive function (from MMSE ≥ 24, 18–23 to 0–17, ANOVA p < 0.001). Multivariable analysis showed that MetS (p = 0.002), abdominal obesity (p < 0.001), low high-density lipoprotein cholesterol (p = 0.004), and hyperglycemia (p = 0.012) were significantly associated with a low MMSE score. Further, participants with high BMI (p = 0.001), WHR (p < 0.001), WHtR (p < 0.001), BRI (p < 0.001), CI (p < 0.001), BAI (p < 0.001), AVI (p < 0.001), and ABSI (p < 0.001) values were significantly associated with a low MMSE score. Our results show that MetS and its components (except for hypertriglyceridemia and high blood pressure) may lead to cognitive impairment, and that high values of obesity-related indices were associated with poor cognitive function.

Previous studies have revealed associations between heavy metals and extensive health problems. However, the association between heavy metals and metabolic problems remains poorly defined. This study aims to investigate relationships between heavy metals and metabolic syndrome (MetS), lipid accumulation product (LAP), visceral adiposity index (VAI), and anthropometric indices, including body roundness index (BRI), conicity index (CI), body adiposity index (BAI), and abdominal volume index (AVI). We conducted a health survey of people living in southern Taiwan. Six heavy metals were measured: lead (Pb) in blood and nickel (Ni), chromium (Cr), manganese (Mn), arsenic (As), and copper (Cu) in urine. A total of 2444 participants (976 men and 1468 women) were enrolled. MetS was defined according to the Adult Treatment Panel III for Asians. Multivariable analysis showed that participants with high urine Ni (log per 1 μg/L; odds ratio (OR): 1.193; 95% confidence interval (CI): 1.019 to 1.397; p = 0.028) and high urine Cu (log per 1 μg/dL; OR: 3.317; 95% CI: 2.254 to 4.883; p < 0.001) concentrations were significantly associated with MetS. There was a significant trend of a stepwise increase in blood Pb and urine Ni, As, and Cu according to the number of MetS components (from 0 to 5, a linear p ≤ 0.002 for trend). For the determinants of indices, urine Cu was positively correlated with LAP, BRI, CI, and VAI; blood Pb was positively correlated with BRI, BAI, and AVI; urine Ni was positively correlated with LAP. High urine Cu and urine Ni levels were significantly associated with MetS, and there was a significant trend for stepwise increases in blood Pb and urine Ni, As, and Cu, accompanied by an increasing number of MetS components. Furthermore, several indices were positively correlated with urine Cu, urine Ni, and blood Pb.

The global pandemic of obesity and the increasing incidence of chronic respiratory diseases are growing health concerns. The association between obesity and pulmonary function is uncertain. Therefore, this study aimed to explore associations between changes in lung function and obesity-related indices in a large longitudinal study. A total of 9059 participants with no personal histories of asthma, smoking, bronchitis, or emphysema were enrolled from the Taiwan Biobank and followed for 4 years. Lung function was assessed using spirometry measurements including forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). Changes in FEV1/FVC (∆FEV1/FVC) between baseline and follow-up were calculated. The following obesity-related indices were studied: lipid accumulation product (LAP), body roundness index (BRI), conicity index (CI), body adiposity index (BAI), abdominal volume index (AVI), body mass index (BMI), waist–hip ratio (WHR), and waist-to-height ratio (WHtR). In multivariable analysis, the subjects with high BMI (p < 0.001), WHR (p < 0.001), WHtR (p < 0.001), LAP (p = 0.002), BRI (p < 0.001), CI (p = 0.005), BAI (p < 0.001), and AVI (p < 0.001) were significantly associated with a high baseline FEV1/FVC. After 4 years of follow-up, the subjects with high BMI (p < 0.001), WHR (p < 0.001), WHtR (p < 0.001), LAP (p = 0.001), BRI (p < 0.001), CI (p = 0.002), BAI (p < 0.001), and AVI (p < 0.001) were significantly associated with a low △FEV1/FVC. High obesity-related index values were associated with better baseline lung function and a rapid decrease in lung function at follow-up.

Dyslipidemia is an important risk factor for hypertension and is strongly associated with an elevated risk of cardiovascular diseases including atherosclerosis and stroke. In this study, we investigated correlations between lipid profiles, including triglycerides, total cholesterol (Chol), high-and low-density lipoprotein cholesterol (HDL-C/LDL-C), and Chol/HDL-C, and baseline and incident hypertension. A total of 26,965 subjects with 4 years of follow-up data were enrolled from the Taiwan Biobank. In the cross-sectional cohort, associations between the prevalence of hypertension and lipid profiles were examined in all study participants (n = 26,965). In the longitudinal cohort, these associations were further assessed in the participants without baseline hypertension (n = 21,454). Multivariable analysis revealed that those in the second quartile (Q2) of triglycerides (compared to Q1; odds ratio (OR), 1.402; p < 0.001); Q3 of triglycerides (compared to Q1; OR, 1.365; p < 0.001); Q4 of triglycerides (compared to Q1; OR, 1.617; p < 0.001); Q3 of HDL-C (compared to Q1; OR, 0.886; p = 0.042); Q4 of HDL-C (compared to Q1; OR, 0.819; p = 0.002); Q2 of Chol/HDL-C (compared to Q1; OR, 1.144; p = 0.042); Q3 of Chol/HDL-C (compared to Q1; OR, 1.149; p = 0.034); and Q4 of Chol/HDL-C (compared to Q1; OR, 1.225; p = 0.002) were significantly associated with incident hypertension. In summary, high Chol/HDL-C, low HDL-C, and high triglycerides were associated with a higher risk of incident hypertension in the enrolled Taiwanese participants.