Abstract
Obesity, defined conventionally by Basal Mass Index (BMI), is associated with numerous cardiac complications such as coronary heart disease, heart failure, and sudden death. However, not all obese people are affected by metabolic disturbances and a subset of normal BMI individuals suffer from metabolic syndrome (MetS). Although these phenotypes have been recognized by researchers, there is a paucity of data for obese people without MetS (MHO) (MetS+/Obe-). This study examined the prevalence of different definitions of obesity and their association with Coronary Artery Disease (CAD) in a Malay rural population. Method: The group, an 18 month cross sectional, hospital based study, comprised 408 patients who were nonsmokers, age 20 and above, both gender and all races. We used differing definitions of obesity based on BMI, the consequences of obesity by these different definitions and ethnic associations. Results: In patients with BMI ≥ 25, ≥ 27, and ≥ 30, the percentages of MHO were 15.4, 10.8 and 5.7% respectively. Obese, metabolic abnormal groups (MetS+/Obe+) (MOO) defined at BMI ≥ 25 (1.92, CI =1.16-3.17), ≥ 27 (1.94, CI=1.18-3.17) and non-obese, metabolic abnormal group with BMI<30 (MetS+/Obe-) (MONO) (1.71, CI=1.04-2.80) were significantly associated with CAD. Conclusion: Obese, metabolic abnormal groups (MetS+/Obe+) (with obesity defined as BMI ≥ 25, ≥ 27) and metabolic abnormal group (MetS+/Obe-) with BMI <30 (with obesity defined as BMI ≥ 30) were significantly associated with CAD but obese metabolic normal subjects (Mets+/Obe-) (MHO) with BMI <27 were not significantly associated with CAD.
Highlights
Obesity statistics from the 2006 Malaysian National Health and morbidity Survey showed 43% of Malaysian adults were overweight or obese as was 38% of child population
Obese, metabolic abnormal groups (MetS+/Obe+) and metabolic abnormal group (MetS+/Obe-) with Basal Mass Index (BMI)
There is a subset of normal weight individuals who suffer from metabolic disturbances, i.e., Non-Obese Metabolically Obese (NOMO)
Summary
Obesity statistics from the 2006 Malaysian National Health and morbidity Survey showed 43% of Malaysian adults were overweight or obese as was 38% of child population. There are individuals in the population who have different phenotypes such as phenotypically obese but metabolically healthy (MHO); phenotypically not obese but metabolically unhealthy (NOMO); and other healthy in both categories. In the last WHO Expert Consultation addressing the issue of setting different cut points for BMI in Asian populations, the committee agreed that overweight or obese Asians are generally at higher risk for diabetes mellitus and cardiovascular disease than Europeans of similar age, sex, and BMI [4].
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