TY - JOUR
T1 - Dietary and plasma carboxymethyl lysine and tumor necrosis factor-α as mediators of body mass index and waist circumference among women in indonesia
AU - Liman, Patricia Budihartanti
AU - Agustina, Rina
AU - Djuwita, Ratna
AU - Umar, Jahja
AU - Permadhi, Inge
AU - Helmizar,
AU - Hidayat, Adi
AU - Feskens, Edith J.M.
AU - Abdullah, Murdani
N1 - Funding Information:
Funding: This study was supported by grants from the Indonesian Ministry of Education and Culture through Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON). This publication was funded by the Directorate of Research and Community Engagement of Universitas Indonesia (Number: NKB-3049/UN2.R3.1/HKP05.00/2019).
Funding Information:
This study was supported by grants from the Indonesian Ministry of Education and Culture through Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON). This publication was funded by the Directorate of Research and Community Engagement of Universitas Indonesia (Number: NKB-3049/UN2.R3.1/HKP05.00/2019). The authors like to thank the subjects for their participation and all enumerators of this study for their assistance. We also gratefully acknowledge the stimulating discussions of Anuraj H. Shankar, D.Sc and Ninik Mudjihartini, MS during the study and the proofreading of the manuscript by Richard Tjan, DTMH (Mahidol). Thanks, are also due to Drs: Shiela Stefani, Sanny Ngatidjan, Kurnia Agustina Sitompul, and Monica Paotiana for data collection and entry. Part of this material has been disclosed at an International conference on Nutrition.
Publisher Copyright:
© 2019 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2019/12
Y1 - 2019/12
N2 - Dietary and plasma carboxymethyl lysine (dCML, pCML) and plasma tumor necrosis factor-α (pTNF-α) may be associated with obesity in affluent society. However, evidence in women from low-middle income countries with predominantly traditional diets is lacking. We investigated the mediator effects of dCML, pCML and pTNF-α on body mass index (BMI) and waist circumference (WC) among Indonesian women. A cross-sectional study was conducted among 235 non-diabetic, non-anemic and non-smoking women aged 19–50 years from selected mountainous and coastal areas of West Sumatra and West Java. Dietary CML, pCML, pTNF-α were obtained from 2 × 24-h recalls, ultra-performance liquid chromatography-tandem mass spectrometry and enzyme-linked immunosorbent assay, respectively. Between-group differences were analyzed by the Chi-square or Mann-Whitney test and mediator effects by Structural Equation Modeling. The medians and interquartile-ranges of dCML, pCML and pTNF-α were 2.2 (1.7–3.0) mg/day, 22.2 (17.2–28.2) ng/mL and 0.68 (0.52–1.00) IU/mL, respectively, and significantly higher in the WC ≥ 80 cm than in the WC < 80 cm group, but not in BMI ≥ 25 kg/m2 compared to BMI < 25 kg/m2 group. Plasma CML and pTNF-α were positively and directly related to WC (β = 0.21 [95% CI: 0.09, 0.33] and β = 0.23 [95% CI: 0.11, 0.35], respectively). Dietary CML that correlated with dry-heat processing and cereals as the highest contributions was positively related to WC (β = 0.33 [95% CI: 0.12, 0.83]). Ethnicity, level of education, intake of fat, and intake of energy contributed to dCML, pCML and pTNF-α, and subsequently affected WC, while only ethnicity contributed to BMI through dCML, pCML and pTNF-α (β = 0.07 [95% CI: 0.01, 0.14]). A positive direct effect of dCML on pCML and of pCML and pTNF-α on WC was seen among Indonesian women. Dietary CML seems to have several paths that indirectly influence the increases in WC if compared to BMI. Thus, intake of CML-rich foods should be reduced, or the foods consumed in moderate amounts to avoid the risk of central obesity in this population.
AB - Dietary and plasma carboxymethyl lysine (dCML, pCML) and plasma tumor necrosis factor-α (pTNF-α) may be associated with obesity in affluent society. However, evidence in women from low-middle income countries with predominantly traditional diets is lacking. We investigated the mediator effects of dCML, pCML and pTNF-α on body mass index (BMI) and waist circumference (WC) among Indonesian women. A cross-sectional study was conducted among 235 non-diabetic, non-anemic and non-smoking women aged 19–50 years from selected mountainous and coastal areas of West Sumatra and West Java. Dietary CML, pCML, pTNF-α were obtained from 2 × 24-h recalls, ultra-performance liquid chromatography-tandem mass spectrometry and enzyme-linked immunosorbent assay, respectively. Between-group differences were analyzed by the Chi-square or Mann-Whitney test and mediator effects by Structural Equation Modeling. The medians and interquartile-ranges of dCML, pCML and pTNF-α were 2.2 (1.7–3.0) mg/day, 22.2 (17.2–28.2) ng/mL and 0.68 (0.52–1.00) IU/mL, respectively, and significantly higher in the WC ≥ 80 cm than in the WC < 80 cm group, but not in BMI ≥ 25 kg/m2 compared to BMI < 25 kg/m2 group. Plasma CML and pTNF-α were positively and directly related to WC (β = 0.21 [95% CI: 0.09, 0.33] and β = 0.23 [95% CI: 0.11, 0.35], respectively). Dietary CML that correlated with dry-heat processing and cereals as the highest contributions was positively related to WC (β = 0.33 [95% CI: 0.12, 0.83]). Ethnicity, level of education, intake of fat, and intake of energy contributed to dCML, pCML and pTNF-α, and subsequently affected WC, while only ethnicity contributed to BMI through dCML, pCML and pTNF-α (β = 0.07 [95% CI: 0.01, 0.14]). A positive direct effect of dCML on pCML and of pCML and pTNF-α on WC was seen among Indonesian women. Dietary CML seems to have several paths that indirectly influence the increases in WC if compared to BMI. Thus, intake of CML-rich foods should be reduced, or the foods consumed in moderate amounts to avoid the risk of central obesity in this population.
KW - Body mass index
KW - Carboxymethyl lysine
KW - Central obesity
KW - Indonesian women
KW - Tumor necrosis factor-α
KW - Waist circumference
UR - http://www.scopus.com/inward/record.url?scp=85076721842&partnerID=8YFLogxK
U2 - 10.3390/nu11123057
DO - 10.3390/nu11123057
M3 - Article
C2 - 31847322
AN - SCOPUS:85076721842
SN - 2072-6643
VL - 11
JO - Nutrients
JF - Nutrients
IS - 12
M1 - 3057
ER -
