Original article
Association of General and Abdominal Obesity With Hypertension, Dyslipidemia and Prediabetes in the PREDAPS StudyAsociación de obesidad general y abdominal con hipertensión, dislipemia y presencia de prediabetes en el estudio PREDAPS

https://doi.org/10.1016/j.rec.2017.04.035Get rights and content

Abstract

Introduction and objectives

Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin).

Methods

Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30 kg/m2 and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102 cm in men/WC ≥ 88 cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression.

Results

Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08).

Conclusions

Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results.

Resumen

Introducción y objetivos

Algunas medidas antropométricas muestran mayor capacidad que otras para discriminar la presencia de factores de riesgo cardiovascular. Este trabajo estima la magnitud de la asociación de diversos indicadores antropométricos de obesidad con hipertensión, dislipemia y prediabetes (glucemia basal o glucohemoglobina alteradas).

Métodos

Análisis transversal de la información recogida en 2.022 sujetos del estudio PREDAPS (etapa basal). Se definió obesidad general como índice de masa corporal ≥ 30 kg/m2 y obesidad abdominal con 2 criterios: a) perímetro de cintura (PC) ≥ 102 cm en varones/PC ≥ 88 cm en mujeres, y b) índice cintura/estatura (ICE) ≥ 0,55. La magnitud de la asociación se estimó mediante regresión logística.

Resultados

La hipertensión arterial mostró la asociación más alta con la obesidad general en mujeres (OR = 3,01; IC95%, 2,24-4,04) y con la obesidad abdominal según el criterio del ICE en varones (OR = 3,65; IC95%, 2,66-5,01). La hipertrigliceridemia y los valores bajos de colesterol unido a lipoproteínas de alta densidad mostraron la asociación más alta con obesidad abdominal según el criterio del ICE en mujeres (OR = 2,49; IC95%, 1,68-3,67 y OR = 2,70; IC95%, 1,89-3,86) y la obesidad general en varones (OR = 2,06; IC95%, 1,56-2,73 y OR = 1,68; IC95%, 1,21-2,33). La prediabetes mostró la asociación más alta con obesidad abdominal según el criterio del ICE en mujeres (OR = 2,48; IC95%, 1,85-3,33) y con obesidad abdominal según el criterio del PC en varones (OR = 2,33; IC95%, 1,75-3,08).

Conclusiones

Los indicadores de obesidad abdominal mostraron la mayor asociación con la presencia de prediabetes. La relación de los indicadores antropométricos con hipertensión y con dislipemia mostró resultados heterogéneos.

Section snippets

INTRODUCTION

Overweight and obesity are associated with a multitude of health conditions, and the anthropometric indicators used to define obesity can help to identify individuals or populations at specific risk of a diverse range of health problems.1 The many available anthropometric obesity indicators include body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and waist-height ratio (WHtR). Associations have been sought between these indicators and important cardiovascular and

Study Participants

The study population included 2022 participants aged between 30 and 74 years enrolled in the PREDAPS study. PREDAPS is an observational follow-up study conducted by 125 primary care physicians as part of their routine clinical practice at locations across Spain. PREDAPS is classified by the Agencia Española de Medicamentos y Productos Sanitarios (Spanish Medicines Agency) as an obervational nonpostauthorization study, and the protocol was approved by the Parc de Salut Mar Clinical Research

RESULTS

A total of 2022 patients participated in the study: 589 women and 595 men with prediabetes and 450 women and 388 men with normal carbohydrate metabolism. Stratification of the prediabetes and nonprediabetes groups according to a range of characteristics is shown in Table 1. For both women and men, stratification by age revealed statistically significant between-group differences, Moreover, women and men with prediabetes more frequently had a family history of diabetes, HT, dyslipidemia, or

DISCUSSION

Of the 3 anthropometric indicators studied, WHtR showed the strongest association with dyslipidemia in women and with HT in men, whereas BMI showed the strongest association with HT in women and with dyslipidemia in men. Compared with BMI, both abdominal obesity indicators showed a stronger association with prediabetes, except among men who met both prediabetes critieria: impaired fasting glucose and impaired HbA1c.

Previous studies indicated that abdominal obestity can induce a state of insulin

CONCLUSIONS

Compared with the general obesity indicator, abdominal obesity indicators show a stronger association with prediabetes, except among men with alterations to both fasting plasma glucose and HbA1c. The results do not show a consistent pattern of association between anthropometric indicators and the presence of HT and dyslipidemia

FUNDING

This study received funding from Novartis and Sanofi for the development of the telematic data-collection platform, researcher meetings, and study monitoring. Sanofi and Novartis did not participate in the study design, data analysis and interpretation, manuscript writing, or the decision to submit the manuscript for publication. This study was possible thanks to the infrastructure provided by the Fundación redGDPS (Spanish acronym for Research Network into Diabetes in Primary Health Care).

CONFLICTS OF INTEREST

None declared.

WHAT IS KNOWN ABOUT THE TOPIC?

  • –

    Abdominal obesity is a better predictor than general obesity of cardiometabolic risk.

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    Some studies have identified WHtR as the abdominal obesity indicator most strongly associated with altered fasting plasma glucose, diabetes, cardiovascular risk factors, and metabolic syndrome.

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    It is unknown if WHtR shows a stronger association than general obesity with prediabetes, under a broad definition that includes altered HbA1c.

WHAT DOES THIS STUDY ADD?

  • –

    WHtR shows the strongest association with dyslipidemia in women

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    © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.