Clinical characteristics and classification of Cameroonians with obesity and metabolically normal phenotype in the West region of Cameroon

Abstract

The objective of this study was to classify and suggest an adequate definition of the metabolically normal phenotype among Cameroonians with obesity in the western Region of Cameroon. A cross-sectional study was conducted in the West Cameroon Region from August 2016 to August 2017. A total of 324 subjects with BMI >27 kg/m2, aged of 20 years and older, and not treated for cardiometabolic diseases were included in the study. Sociodemographic and clinical parameters of the subjects were collected. Four definitions of metabolic status were tested to suggest the definition that best identifies the subjects with obesity but metabolically normal phenotype (MNO) in the study. The prevalence of the MNO phenotype varied from 2.50% to 29.60% according to the definitions used. According to the individual definitions, the prevalence of the MNO phenotype was 29.60% according to Hinnouho, 16.00% according to Mbanya, 7.40% according to Meigs and 2.50% according to Widman. Markers of inflammatory profile (high sensitivity C-reactive protein and tumor necrosis factor-alpha), carbohydrate homeostasis (fasting glucose and homeostasis model assessment), markers of lipid profile (total cholesterol and triglyceride), systolic blood pressure, nitric oxide, adiposity indices (Waist circumference and waist to hip ratio) were significantly lower in MNO subjects for the majority of definitions (p < 0.05). The modified Hinnouho definition showed better specificity (60.90%) and sensitivity (12.10%) for an area under the ROC curve of 0.98. The degree of agreement was low between the different pairs of definition of the MNO phenotype (Kappa< 0.61). There is poor agreement between the different definitions of the MNO phenotype among Cameroonians with obesity. Therefore, the adoption of a universal definition of MNO phenotype should be proposed to facilitate the management of metabolic health in people with obesity.