DOI QR코드

DOI QR Code

General and abdominal obesity and risk of cardiometabolic factors in the community dwelling women

순환대사위험요인의 관련성에서 비만지표인자인 허리둘레와 체질량지수의 비교

  • Received : 2017.11.26
  • Accepted : 2018.01.20
  • Published : 2018.01.28

Abstract

The aim of this study was to investigate the cardiometabolic risk factors (CRF) of community dwelling women based on a combination of body mass index (BMI) and waist circumference (WC). This cross-sectional study was based on 1,447 subjects between 30 and 60 years of age. Subjects were categorized into 4 groups by BMI and WC [group 1, BMI<$25kg/m^2$ and WC<85 cm; group 2, BMI<$25kg/m^2$ and WC>85 cm; group 3, BMI>$25kg/m^2$ and WC<85 cm; and group 4 (BMI>$25kg/m^2$ and WC>85 cm. Logistic regression analyses showed that subjects in group 2 had 1.75 times increased risk of clustering of 2 or more CRFs compared with subjects in group 1 (p<0.001). In conclusion, early detection of people with normal weight but high waist circumference may prevent them from getting worse by implementation of lifestyle intervention, consisting of regular exercise and healthy eating. In addition, further studies on appropriate exercise contents for them should be examined.

Keywords

Abdominal obesity;General obesity;Cardiometabolic factors;Women;Waist circumference

References

  1. World Health Organization, "Obesity: preventing and managing the global epidemic. Report of a WHO Consultation on Obesity." Geneva, Switzerland: World Health Organization, 1998
  2. National Institutes of Health, "Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults-the evidence report." Obes Res, Vol. 6, pp. 51S-209S, 1998. https://doi.org/10.1002/j.1550-8528.1998.tb00690.x
  3. G. A. Colditz, W. C. Willett, A Rotnitzky, J. E. Manson, "Weight gain as a risk factor for clinical diabetes mellitus in women." Ann Intern Med, Vol. 122, No. 7, pp. 481-486, 1995. https://doi.org/10.7326/0003-4819-122-7-199504010-00001
  4. E. E. Calle, M. J. Thun, J. M. Petrelli, C. Rodriguez, W. Heath, "Body-mass index and mortality in a prospective cohort of U.S. adults." N Engl J Med., Vol. 341, No. 15, pp. 1097-1105, 1999. https://doi.org/10.1056/NEJM199910073411501
  5. C. J. Lavie, R. V. Milani, H. O. Ventura, "The "obesity paradox" in coronary heart disease." Am J Cardiol, Vol. 106, No. 11, pp. 1673, 2010.
  6. WHO Expert Consultation, "Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies." Lancet, Vol. 363, No. 9403, pp. 157-163, 2004. https://doi.org/10.1016/S0140-6736(03)15268-3
  7. C. J. Lavie, A, De Schutter, D. Patel, S. M. Artham, R. V. Milani, "Body composition and coronary heart disease mortality-an obesity or a lean paradox?" Mayo Clinic Proc, Vol. 86, No. 9, pp. 857-864, 2011. https://doi.org/10.4065/mcp.2011.0092
  8. C. J. Lavie, R. V. Milani, H. O. Ventura, "Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss." J Am Coll Cardiol, Vol. 53, No. 21, pp. 1925-1932, 2009. https://doi.org/10.1016/j.jacc.2008.12.068
  9. A. R. Folsom, L. H. Kushi, K. E. Anderson, P. J. Olson, J. E., Hong, C. P, T. A. Sellers, D. Lazovich, R. J. Prineas, "Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women's Health Study." Arch Intern Med, Vol. 160, No. 14, pp. 2117-2128, 2000. https://doi.org/10.1001/archinte.160.14.2117
  10. Kissebah, A. H., Vydelingum, N., Murray, R., Evans, D. J., Hartz, A. J., Kalkhoff, R. K., Adams, P. W., "Relation of body fat distribution to metabolic complications of obesity." J Clin Endocrin Metab, Vol. 54, No. 2, pp. 254-260, 1982. https://doi.org/10.1210/jcem-54-2-254
  11. T. Coutinho, K. Goel, D. Correa de Sa, R. E. Carter, D. O. Hodge, C. Kragelund, A. M. Kanaya, M. Zeller, J. S. Park, L. Kober, C. Torp-Pedersen, Y. Cottin, L. Lorgis, S. H. Lee, K. Y. Kim, R. Thomas, V. L. Roger, V. K. Somers, F. Lopez-Jimenez, "Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: role of "normal weight central obesity," J Am Coll Cardiol, Vol. 61, No. 5, pp. 553-560, 2013. https://doi.org/10.1016/j.jacc.2012.10.035
  12. S. Zhu, Z. Wang, S. Heshka, M. Heo, M. S. Faith, S. B. Heymsfield, "Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds." AmJ Clin Nutr, Vol. 76, No. 4, pp. 743-749, 2002. https://doi.org/10.1093/ajcn/76.4.743
  13. C. Palacios, C. M. Manue, M. Guzman, A. P. Ortiz, A. Ayala, A. Suarez, "Association between adiposity indices and cardiometabolic risk factors among adults living in Puerto Rico," Public Health Nutrition: Vol. 14, No. 10, pp. 1714-1723, 2011. https://doi.org/10.1017/S1368980011000796
  14. S. Czernichow, A. P. Kengne, R. R. Huxley, G. D. Batty, B. D. Galan, S. Zoungas, M. Marre, M. Woodward, B. Neal, 'Comparison of waist-to-hip ratio and other obesity indices as predictors of cardiovascular disease risk in people with type 2 diabetes: a prospective cohort study from ADVANCE. Eur J Cardiovasc Prev Rehabil. Vol. 18, No. 2: pp. 312-319, 2011. https://doi.org/10.1097/HJR.0b013e32833c1aa3
  15. S. H. Shin, J. M. Kim, S. C. Sung, H. S. Kim, "Prevalence and Associated Characteristics of Metabolically Healthy Obese Phenotypes in a Community Dwelling Population." J Obesity & Metab Synd, Vol. 26, No. 2, pp. 130-137, 2017. https://doi.org/10.7570/jomes.2017.26.2.130
  16. Korean Society for the Study of Obesity, "Obesity Treatment Guidelines 2012," Korean Society for the Study of Obesity, 2012.
  17. National Cholesterol Education Program (NCEP) Expert Panel on Detection E, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), "Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report." Circulation, Vol. 106, No. 25, pp. 3143-3421, 2002.
  18. J. Y. Kim, S. H. Han, B. M. Yang, "Implication of High-Body-Fat Percentage on Cardiometabolic Risk in Middle-Aged, Healthy, Normal-Weight Adults." Obesity, Vol. 21, No. 8, pp. 1571-1577, 2013. https://doi.org/10.1002/oby.20020
  19. A. Romero-Corral, V. K. Somers, J. Sierra-Johnson, Y. Korenfeld, S. Boarin, J. Korinek, M. D. Jensen, G. Parati, F. Lopez-Jimenez, "Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality." Eur Heart J, Vol. 31, No. 6, pp. 737-746, 2010. https://doi.org/10.1093/eurheartj/ehp487
  20. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention, "Korea Health Statistics 2014: Korea National Health and Nutrition Examination Survey (KNHANES V-2)" Sejong, Ministry of Health and Welfare, 2015.
  21. Y. L. Lym, S. W. Hwang, H. J. Shim, E. H. Oh, Y. S. Chang, B. L. Cho, "Prevalence and Risk Factors of the Metabolic Syndrome as Defined by NCEP-ATP III" J Korean Acad Fam Med, Vol. 24, No. 2, pp. 135-143, 2003.
  22. F. Conus, D. B. Allison, R. Rabasa-Lhoret, M. St-Onge, D. H. St-Pierre, A. Tremblay-Lebeau, E. T. Poehlman, "Metabolic and behavioral characteristics of metabolically obese but normal-weight women." J Clin Endocrinol Metab, Vol. 89, No. 10, pp. 5013-5020, 2004. https://doi.org/10.1210/jc.2004-0265
  23. D. C. Lee, X. Sui, T. S. Church, I. M. Lee, S. N. Blair, "Associations of cardiorespiratory fitness and obesity with risks of impaired fasting glucose and type 2 diabetes in men." Diabetes care, Vol. 32, No. 2, pp. 257-262, 2009. https://doi.org/10.2337/dc08-1377
  24. J. H. Kim, "Prevalence and Related Factors of Metabolically Obese, Normal-Weight Adolescents" Korean Journal of Health Education and Promotion, Vol. 28, No. 1, pp. 93-101. 2011.
  25. M. Fogelholm, K. Kukkonen-Harjula, "Does physical activity prevent weight gain-a systematic review." Obes Rev, Vol. 1, No. 2, pp. 95-111, 2000. https://doi.org/10.1046/j.1467-789x.2000.00016.x
  26. J. W. Twisk, H. C. Kemper, W. van Mechelen, "Tracking of activity and fitness and the relationship with cardiovascular disease risk factors." Med Sci Sports Exerc, Vol. 32, No. 8, pp. 1455-1461. 2000. https://doi.org/10.1097/00005768-200008000-00014
  27. X. Sui, M. J. LaMonte, J. N. Laditka, J. W. Hardin, N. Chase, S. P. Hooker, S. N. Blair, "Cardiorespiratory fitness and adiposity as mortality predictors in older adults." JAMA, Vol. 298, No. 21, pp. 2507-2516, 2007. https://doi.org/10.1001/jama.298.21.2507
  28. F. Hosseinpanah, M. Barzin, P. Mirmiran, P. Azizi, "Effect of changes in waist circumference on metabolic syndrome over a 6.6-year follow-up in Tehran," European Journal of Clinical Nutrition 64, 879-886, European Journal of Clinical Nutrition, Vol. 64, pp. 879-886, 2010. https://doi.org/10.1038/ejcn.2010.79
  29. V. van Harmelen, A. Dicker, M. Ryden, H. Hauner, F. Lonnqvist, E. Naslund, "Increased lipolysis and decreased leptin production by human omental as compared with subcutaneous preadipocytes," Diabetes Vol. 51, pp. 2029-2036, 2002. https://doi.org/10.2337/diabetes.51.7.2029
  30. R. B. Darren, T. Kasia, M. E. Karen, E. C. Leah, E. S. Ahmed, "Comparison of body mass index and waist circumference as predictors of cardiometabolic health in a population of young Canadian adults." Diabetol Metab Syndr, Vol. 2, No. 1, pp. 28, 2010. https://doi.org/10.1186/1758-5996-2-28
  31. J. B. Meigs, P. W. Wilson, C. S. Fox, R. S. Vasan, D. M. Nathan, L. M. Sullivan, R. B. D'Agostino, "Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease." J Clin Endocrinol Metab, Vol. 91, No. 8, pp. 2906-2912, 2006. https://doi.org/10.1210/jc.2006-0594
  32. R. Rubenoff, "Sarcopenic obesity: the confluence of two epidemics." Obes Res, Vol. 12, No. 6, pp. 887-888, 2004. https://doi.org/10.1038/oby.2004.107
  33. N. B. Ruderman, S. H. Schneider, P. Berchtold, "The "metabolically-obese," normal-weight individual." Am J Clin Nutr, Vol. 34, No. 8, pp. 1617-1621, 1981. https://doi.org/10.1093/ajcn/34.8.1617
  34. M. P. Gill, U. Ricardo, B. Elizabeth, J. B. Christopher, E. F. Astrid, "Weight, shape, and mortality risk in older persons: elevated waist-hip ratio, not high body mass index, is associated with a greater risk of death." AJCN, Vol. 84, No. 2, pp. 449-460, 2006.
  35. S. Tanaka, K. Togashi, T. Rankinen, L. Perusse, A. S. Leon, D. C. Rao, J. S. Skinner, J. H. Wilmore, J. P. Despres, C. Bouchard, "Sex differences in the relationships of abdominal fat to cardiovascular disease risk among normal weight white subjects." Int J Obes Relat Metab Disord, Vol. 28, No. 2, pp. 320-323, 2004. https://doi.org/10.1038/sj.ijo.0802545

Acknowledgement

Supported by : Seoul National University of Science and Technology