Abstract P258: Physical Activity Attenuates the Impact of Obesity on Cardiometabolic Risk: The Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

Background: The impact of higher physical activity on the relationship between adiposity and cardiometabolic risk is not completely understood. Methods: The cross-sectional association between body mass index (BMI) and cardiometabolic risk stratified by intentional physical activity was examined in 6814 Multi-Ethnic Study of Atherosclerosis participants, during 2000-2002. Self-reported physical activity in the lowest quartile (0-105 MET-minutes/wk) was categorized as inactive with the upper three quartiles (123-37,260 MET-minutes/wk) categorized as active. The association of BMI categories of normal-weight, overweight and obese stratified by physical activity status (inactive or active) with cardiometabolic risk factors (low HDL-cholesterol [<50 mg/dL], high triglycerides [TG] [≥200 mg/dl], hypertension [HTN] [BP ≥140/90 or current treatment], insulin resistance [highest quartile of homeostasis model assessment of insulin resistance index (HOMA-IR)], and impaired fasting glucose [IFG] [≥100 mg/dl]/diabetes mellitus [DM]) were assessed using logistic regression analysis, after adjusting for age, gender, race/ethnicity, and current smoking. Results: As expected, overweight and obese participants had a more abnormal risk profile. Among obese participants, those with increased physical activity had reduced odds of insulin resistance (47% lower; p<0.001) and IFG/DM (23% lower; p=0.04). Increased physical activity had a beneficial, but more modest effect on other traditional CVD risk factors ( Table ). Conclusion: A beneficial impact of physical activity on cardiometabolic risk was observed that partially attenuated the abnormal impact of obesity. Odds ratio (95% CI) for cardiometabolic abnormality by BMI-PA category Low-HDL High-TG HTN HOMA-IR IFG/DM Normal Active 1.0 (reference) 1.0 (reference) 1.0 (reference) 1.0 (reference) 1.0 (reference) Normal Inactive 1.3 (1.0-1.7) 1.4 (0.9-2.1) 1.1 (0.8-1.4) 1.1 (0.7-1.7) 1.0 (0.7-1.4) Overweight Active 1.9 (1.6-2.2) 2.1 (1.6-2.6) 1.5 (1.3-1.8) 3.2 (2.5-4.2) 2.1 (1.7-2.5) Overweight Inactive 2.5 (2.0-3.1) 2.0 (1.5-2.8) 1.5 (1.2-1.9) 3.8 (2.8-5.2) 2.1 (1.6-2.7) Obese Active 2.9 (2.4-3.7) 2.5 (1.9-3.4) 2.2 (1.8-2.7) 7.6 (5.6-10.2) 3.4 (2.7-4.4) Obese Inactive 3.1 (2.4-4.1) 2.7 (1.9-3.8) 2.5 (2.0-3.3) 14.3 (10.3-19.7) 4.4 (3.4-5.9)