Abstract
Aim:To determine the independent and commingling effect of android and gynoid percent fat (measured using Dual Energy X-Ray Absorptiometry) on cardiometabolic dysregulation in normal weight American adults.Methods:The 2005–2006 data (n=1802) from the United States National Health and Nutritional Examination Surveys (NHANES) were used in this study. Associations of android percent fat, gynoid percent fat and their joint occurrence with risks of cardiometabolic risk factors were estimated using prevalence odds ratios from logistic regression analyses.Results:Android-gynoid percent fat ratio was more highly correlated with cardiometabolic dysregulation than android percent fat, gynoid percent fat or body mass index. Commingling of android and gynoid adiposities was associated with much greater odds of cardiometabolic risk factors than either android or gynoid adiposities. Commingling of android and gynoid adiposities was associated with 1.75 (95% confidence interval (CI)=1.42–2.93), 1.48 (95% CI=1.32–1.91), 1.61 (95% CI=1.50–1.89), 3.56 (95% CI=2.91–4.11) and 1.86 (95% CI=1.49–1.96) increased odds of elevated glucose, elevated blood pressure, elevated low-density lipoprotein-cholesterol, elevated triglyceride and low high-density lipoprotein-cholesterol, respectively.Conclusions:Normal weight subjects who present with both android and gynoid adiposities should be advised of the associated health risks. Both android and gynoid fat accumulations should be considered in developing public health strategies for reducing cardiometabolic disease risk in normal weight subjects.
Highlights
Adiposity is a heterogeneous and multifaceted disorder in which subgroups of obese subjects present varying cardiometabolic profiles
Overall (Table 3), and after adjusting for age, body mass index (BMI), sex, smoking and alcohol intake, elevated android percent fat was associated with increased odds of elevated glucose (OR = 1.31; 95% confidence intervals (CI) = 1.12–2.93), elevated blood pressure (BP) (OR = 1.42; 95% CI = 1.22–2.11), elevated LDL-cholesterol (OR = 1.22; 95% CI = 1.03–1.60), elevated triglycerides (OR = 2.59; 95% CI = 1.61–3.98) and low high-density lipoprotein (HDL)-cholesterol (OR = 1.79; 95% CI = 1.47–1.89)
This study showed gender differences in the response of glucose (OR = 2.24; 95% CI = 2.01–2.93), elevated BP
Summary
Adiposity is a heterogeneous and multifaceted disorder in which subgroups of obese subjects present varying cardiometabolic profiles. Compared with metabolically healthy normal weight subjects, metabolically healthy obese subjects and metabolically unhealthy obese subjects have increased risk of developing type 2 diabetes, cardiovascular diseases and all-cause mortality.[8,9] Metabolically healthy normal weight subjects often do not present with clusters of metabolic and cardiovascular risk factors similar to what is often associated with being overweight or obese such as elevated fasting glucose, insulin resistance, increased triglyceride and decreased high-density lipoprotein (HDL)-cholesterol levels, and systemic inflammation.[10] It is estimated that the metabolically unhealthy normal weight and metabolically healthy normal weight subgroups represent about 25% and 35% of the population, respectively.[10,11] Whereas many of the adiposity phenotypes are defined using body mass index (BMI), little is known about normal weight subjects who are abdominally obese and their risks for cardiometabolic risk factors. Using a more accurate measurement of site-specific body fat defined elevated android and gynoid percent fat with cardiometabolic risk factors, (ii) whether commingling of android and gynoid percent fat is associated with greater cardiometabolic deregulation than their independent effect in normal weight American adults
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