Abstract
BackgroundIndividuals with transition from metabolically healthy overweight/obese (MHO) to metabolically unhealthy overweight/obese (MUO) phenotype are significantly predisposed to greater risks of cardiovascular events compared to those with a persistent MHO phenotype. The aim of this study was to evaluate the predictive performance of wrist circumference for this transition in adults over a 15.5-year follow-up.MethodsWe included 309 males and 821 females with the age of ≥18 years old, body mass index ≥25 kg/m2, and metabolically healthy status according to the criteria of the Joint Interim Statement. The incidence of MUO phenotype was evaluated for each gender, across tertiles wrist circumference, using Cox-proportional hazard models.ResultsThe overall rate of transition from MHO to MUO phenotype was 87.1% in males and 77.5% in females. The hazard ratios (HRs) with 95% CI across second and third tertiles of wrist circumference were 0.89 (0.64-1.24) and 1.31 (0.99-1.73) in men (P for trend =0.027); and 1.34 (1.09-1.66) and 1.61 (1.30-2.00) in women (P for trend <0.001), respectively. After multivariable adjustment, HRs across second and third tertiles of wrist circumference were 0.92 (0.64-1.32) and 1.18 (0.83-1.67) in males (p for trend =0.352), and 1.32 (1.05-1.65) and 1.34 (1.06-1.96) in females (p for trend =0.025), respectively.ConclusionsWrist circumference significantly predicts the transition from MHO to MUO phenotype in adults of both genders. However, it is an independent predictor of the transition only in females. Future studies are warranted to clarify the role of wrist circumference mechanisms on metabolic risk deterioration.
Highlights
The prevalence of obesity is rising worldwide [1]
Interaction between wrist circumference and gender at transition from metabolically healthy overweight/obese (MHO) to metabolically unhealthy overweight/obese (MUO) phenotype was tested by the log-likelihood ratio test, and since we found a significant interaction (P =0.037), the analyses were performed in males and females, separately
The ratio of smokers, systolic blood pressure (SBP), and serum Fasting plasma glucose (FPG) and triglycerides were higher, and serum High-density lipoprotein (HDL) level was lower in males compared to females while no significant differences were seen regarding physical activity and serum levels of total cholesterol (TC) and Low-density lipoprotein (LDL) between genders
Summary
The prevalence of obesity is rising worldwide [1]. Obesity is regarded as an independent risk factor for a broad spectrum of non-communicable and cardiovascularMousapour et al BMC Public Health (2021) 21:2276 circumference. An extensive body of literature supports that MHO can be a transient condition, and approximately 30 to 50% of individuals with MHO have shown transition to metabolically unhealthy overweight/obese (MUO) phenotype during 4 to 20 years of follow-up [5]. Compelling evidence supports that in comparison with metabolically healthy normal weight individuals, those with MHO phenotype are at an increased risk of CVDs but only when they are followed up for at least 10 years [6, 7]. MHO individuals at transition to MUO are significantly predisposed to greater risks of CVDs compared to those with persistent MHO phenotype [8,9,10]. Individuals with transition from metabolically healthy overweight/obese (MHO) to metabolically unhealthy overweight/obese (MUO) phenotype are significantly predisposed to greater risks of cardiovascular events compared to those with a persistent MHO phenotype. The incidence of MUO phenotype was evaluated for each gender, across tertiles wrist circumference, using Cox-proportional hazard models
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