METABOLIC DISTURBANCES IN ABDOMINAL OBESITY

Introduction: Increased waist circumference is an independent risk factor for cardio-vascular complications and mortality and current studies focus on describing the factors involved in its etiology and pathogeny. The objective of this study was to analyze all components of the metabolic syndrome in subjects with increased waist circumference, with the hypothesis that even in normal weighted apparently healthy subjects the metabolic profile is already modified. Materials and methods: A cross-sectional study was conducted between February 2013 and April 2014. The sample consisted of 266 consecutive patients presenting to the Endocrinology Outpatient Clinic of the Emergency Mures County Hospital for consultation who signed the informed consent. Inclusion criteria - waist circumference above 80cm for females and >94cm for males. Exclusion criteria - secondary causes of increased abdominal circumference: pregnancy, generalized edema, endocrine causes: untreated hypo-or hyperthyroidism, Cushing syndrome, medications that could lead to weight gain/loss, weight losing diet and refusal to participate. For all patients, height, weight, waist circumference and blood pressure were measured by the same person. Venous blood samples were taken for determination of fasting blood glucose, triglycerides and HDL cholesterol. Microsoft Office Excel was used for data collection and GraphPad Prism v. 5 for statistical analysis, with a level of significance alpha=0.05. Results: Mean age of the sample was 51 +/- 12.7 years with a median of 53 years and a sex ratio F:M of 8.1:1. The normal weighted subjects had a high prevalence of associated disturbances (34.41% hypertriglyceridemia, 37.63% low HDL cholesterol, 29.03% increased blood glucose and 44.09% hypertension). Metabolically healthy obese represented 17.29% (n=46) of the sample. When comparing the metabolically healthy subjects with abdominal obesity to the metabolically unhealthy subjects, the former are younger (41.4 vs. 53.1 years, p<0.0001), thinner (BMI 28.7 vs. 32.5 kg/sqm, p<0.0001) and with significantly smaller differences of the waist compared to the IDF cut-offs (11 vs. 20.2cm, p<0.0001). Conclusions: Waist circumference is an important clinical parameter which correlates with all the elements of the metabolic syndrome. Increased waist circumference should elicit metabolical evaluation and lifestyle modifications.