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Exp Clin Endocrinol Diabetes 2018; 126(05): 309-315
DOI: 10.1055/s-0043-119877
Article
© Georg Thieme Verlag KG Stuttgart · New York

Gender Differences in Cardiometabolic Risk Factors in Metabolically Healthy Normal Weight Adults with Central Obesity

Katarína Šebeková
1   Institute of Molecular BioMedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
,
Melinda Csongová
1   Institute of Molecular BioMedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
,
Radana Gurecká
1   Institute of Molecular BioMedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
2   Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
,
Zora Krivošíková
3   Department of Clinical and Experimental Pharmacology, Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia
,
Jozef Šebek
4   Institute of Materials & Machine Mechanics, Slovak Academy of Sciences, Bratislava, Slovakia
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Publikationsverlauf

received 02. August 2017
first decision 11. September 2017

accepted 18. September 2017

Publikationsdatum:
08. November 2017 (online)

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Abstract

We investigated whether metabolically healthy normal weight adults with central obesity display worse cardiometabolic profile compared with their centrally lean counterparts. This retrospective, cross-sectional study, comprised 1 135 subjects (64% females) aged 18-to-81 years, presenting ≤2 components of metabolic syndrome. They were classified as centrally lean (waist-to-height ratio (WHtR)<0.5 and waist circumference<80 cm in females and<94 cm in males) or presenting central obesity (WHtR ≥0.5, regardless of waist circumference). Data on blood pressure, glucose homeostasis, lipid profile, renal function, high-sensitive C-reactive protein (hsCRP), uric acid, adiponectin, leptin, and soluble receptor for advanced glycation end products were compared between the groups, separately in males and females. 5.7% of males and 6.9% of females presented WHtR ≥0.5. Compared with centrally lean subjects, those with central obesity had higher BMI-adjusted fasting plasma glucose (p<0.001), and leptin levels (p<0.05); females also presented higher blood pressure (p<0.001), while males had higher hsCRP concentrations (p=0.021). These changes associated with significantly higher BMI-adjusted odds to present fasting plasma glucose >5.6 mmol/l in both genders, higher odds to present hsCRP >3 mg/l in males, and those to present elevated blood pressure in females. Our analysis suggests that in metabolically healthy normal weight subjects WHtR ≥0.5 might indicate “early increased health risk”.

Key words

waist-to-height ratio - fasting plasma glucose - blood pressure - hsCRP - leptin

Supplementary Material

 

  • References

  • 1 Meigs JB, Wilson PWF, Fox CS. et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab 2006; 91: 2906-2912
    CrossrefPubMedGoogle Scholar
  • 2 Browning LM, Hsieh SD, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value. Nutr Res Rev 2010; 23: 247-269
    CrossrefPubMedGoogle Scholar
  • 3 Ashwell M, Gibson S. Waist-to-height ratio as an indicator of "early health risk': Simpler and more predictive than using a "matrix' based on BMI and waist circumference. BMJ Open 2016; 6: e010159
    CrossrefPubMedGoogle Scholar
  • 4 Alberti KG, Eckel RH, Grundy SM. et al. Harmonizing the Metabolic Syndrome A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120: 1640-1645
    CrossrefPubMedGoogle Scholar
  • 5 Dobiasova M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: Correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)). Clin Biochem 2001; 34: 583-588
    CrossrefPubMedGoogle Scholar
  • 6 Katz A, Nambi SS, Mather K. et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 2000; 85: 2402-2410
    CrossrefPubMedGoogle Scholar
  • 7 Rochlani Y, Pothineni NV, Mehta JL. Metabolic syndrome: Does it differ between women and men?. Cardiovasc Drugs Ther 2015; 29: 329-338
    CrossrefPubMedGoogle Scholar
  • 8 Pradhan AD. Sex differences in the metabolic syndrome: Implications for cardiovascular health in women. Clin Chem 2014; 60: 44-52
    CrossrefPubMedGoogle Scholar
  • 9 Csongová M, Gurecká R, Koborová I. et al. Waist circumference vs. waist-to-height ratio in estimation of central obesity in Slovak adults. Obes facts 2015; 8: 149
    PubMedGoogle Scholar
  • 10 K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Am J Kidney Dis 2002; 39: S1-266
    PubMedGoogle Scholar
  • 11 Martin SS, Qasim A, Reilly MP. Leptin resistance – A possible interface of inflammation and metabolism in obesity-related cardiovascular disease. J Am Coll Cardiol 2008; 52: 1201-1210
    CrossrefPubMedGoogle Scholar
  • 12 de Castro MA, Baltar VT, Marchioni DML. et al. Sex differences in serum leptin and its relation to markers of cardiometabolic risk in middle-aged adults: Evidence from a population-based study. Nutrition 2015; 31: 491-497
    CrossrefPubMedGoogle Scholar
  • 13 Mokan M, Galajda P, Pridavkova D. et al. Prevalence of diabetes mellitus and metabolic syndrome in Slovakia. Diabetes Res Clin Pract 2008; 81: 238-242
    CrossrefPubMedGoogle Scholar
  • 14 Unwin N, Shaw J, Zimmet P. et al. Impaired glucose tolerance and impaired fasting glycaemia: The current status on definition and intervention. Diabet Med 2002; 19: 708-723
    CrossrefPubMedGoogle Scholar
  • 15 Franks PW, Brage S, Luan J. et al. Leptin predicts a worsening of the features of the metabolic syndrome independently of obesity. Obes Res 2005; 13: 1476-1484
    CrossrefPubMedGoogle Scholar
  • 16 Srinivasan SR, Wang R, Chen W. et al. Utility of waist-to-height ratio in detecting central obesity and related adverse cardiovascular risk profile among normal weight younger adults (from the Bogalusa Heart Study). Am J Cardiol 2009; 104: 721-724
    CrossrefPubMedGoogle Scholar
  • 17 Lihn AS, Pedersen SB, Richelsen B. Adiponectin: Action, regulation and association to insulin sensitivity. Obes Rev 2005; 6: 13-21
    CrossrefPubMedGoogle Scholar
  • 18 Mather KJ, Goldberg RB. Clinical use of adiponectin as a marker of metabolic dysregulation. Best Pract Res Clin Endocrinol Metab 2014; 28: 107-117
    CrossrefPubMedGoogle Scholar
  • 19 Hung J, McQuillan BM, Thompson PL. et al. Circulating adiponectin levels associate with inflammatory markers, insulin resistance and metabolic syndrome independent of obesity. Int J Obes (Lond) 2008; 32: 772-779
    CrossrefPubMedGoogle Scholar
  • 20 Yatagai T, Nagasaka S, Taniguchi A. et al. Hypoadiponectinemia is associated with visceral fat accumulation and insulin resistance in Japanese men with type 2 diabetes mellitus. Metabolism 2003; 52: 1274-1278
    CrossrefPubMedGoogle Scholar
  • 21 Gondim OS, de Camargo VTN, Gutierrez FA. et al. Benefits of regular exercise on inflammatory and cardiovascular risk markers in normal weight, overweight and obese adults. Plos One 2015; 10: e0140596
    CrossrefPubMedGoogle Scholar
  • 22 Oka R, Miura K, Sakurai M. et al. Impacts of visceral adipose tissue and subcutaneous adipose tissue on metabolic risk factors in middle-aged Japanese. Obesity 2010; 18: 153-160
    CrossrefPubMedGoogle Scholar
  • 23 Fox CS, Massaro JM, Hoffmann U. et al. Abdominal visceral and subcutaneous adipose tissue compartments – Association with metabolic risk factors in the Framingham Heart Study. Circulation 2007; 116: 39-48
    CrossrefPubMedGoogle Scholar
  • 24 Bell BB, Rahmouni K. Leptin as a Mediator of obesity-induced hypertension. Curr Obes Rep 2016; 5: 397-404
    CrossrefPubMedGoogle Scholar
  • 25 Kalil GZ, Haynes WG. Sympathetic nervous system in obesity-related hypertension: mechanisms and clinical implications. Hypertens Res 2012; 35: 4-16
    CrossrefPubMedGoogle Scholar
  • 26 Hribal ML, Fiorentino TV, Sesti G. Role of C Reactive Protein (CRP) in Leptin Resistance. Curr Pharm Des 2014; 20: 609-615
    CrossrefPubMedGoogle Scholar
  • 27 Park JS, Cho MH, Nam JS. et al. Visceral adiposity and leptin are independently associated with C-reactive protein in Korean type 2 diabetic patients. Acta Diabetol 2010; 47: 113-118
    CrossrefPubMedGoogle Scholar
  • 28 Shamsuzzaman ASM, Winnicki M, Wolk R. et al. Independent association between plasma leptin and C-reactive protein in healthy humans. Circulation 2004; 109: 2181-2185
    CrossrefPubMedGoogle Scholar
  • 29 Miazgowski T, Major-Goluch A, Safranow K. Selected adipokines and metabolic profiles in normal-weight women with abdominal obesity. Pol Arch Med Wewn 2012; 122: 406-412
    PubMedGoogle Scholar
  • 30 Hosseini M, Baikpour M, Yousefifard M. et al. Blood pressure percentiles by age and body mass index for adults. EXCLI J 2015; 14: 465-477
    PubMedGoogle Scholar
  • 31 Song LL, Shen LJ, Li H. et al. Height and prevalence of hypertension in a middle-aged and older Chinese population. Sci Rep 2016; 6: 39480
    CrossrefPubMedGoogle Scholar
  • 32 Bierhaus A, Humpert PM, Morcos M. et al. Understanding RAGE, the receptor for advanced glycation end products. J Mol Med (Berl) 2005; 83: 876-886
    CrossrefPubMedGoogle Scholar
  • 33 Brett J, Schmidt AM, Yan SD. et al. Survey of the distribution of a newly characterized receptor for advanced glycation end products in tissues. Am J Pathol 1993; 143: 1699-1712
    PubMedGoogle Scholar
  • 34 Gurecka R, Koborova I, Csongova M. et al. Correlation among soluble receptors for advanced glycation end-products, soluble vascular adhesion protein-1/semicarbazide-sensitive amine oxidase (sVAP-1) and cardiometabolic risk markers in apparently healthy adolescents: a cross-sectional study. Glycoconj J 2016; 33: 599-606
    CrossrefPubMedGoogle Scholar
  • 35 Dozio E, Briganti S, Delnevo A et al. Relationship between soluble receptor for advanced glycation end products (sRAGE), body composition and fat distribution in healthy women. Eur J Nutr 2016 https://doi.org/10.1007/s00394-016-1291-0
    PubMed
  • 36 Selvin E, Halushka MK, Rawlings AM. et al. sRAGE and risk of diabetes, cardiovascular disease, and death. Diabetes 2013; 62: 2116-2121
    CrossrefPubMedGoogle Scholar