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Variable patterns of obesity and cardiometabolic phenotypes and their association with lifestyle factors in the Di@bet.es study.
Nutr Metab Cardiovasc Dis. 2014 Sep; 24(9):947-55.NM

Abstract

BACKGROUND AND AIM

Prevalence rates of "metabolically healthy obese" (MHO) subjects vary depending on the criteria used. This study examined the prevalence and characteristics of MHO subjects and metabolically abnormal normal-weight subjects and compared the findings with the NHANES 1999-2004 study. The aims of the present study were, first, to determine the prevalence rates of MHO and MNHNO subjects using the same criteria as those of the National Health and Nutrition Examination Survey (NHANES) (1999-2004) study, and second to compare the prevalence and correlates of obese subjects who are resistant to the development of adiposity-associated cardiometabolic abnormalities (CA) and normal-weight individuals who display cardiometabolic risk factor clustering between the Spanish and the US populations.

METHODS AND RESULTS

Di@bet.es study is a national, cross-sectional population-based survey of 5728 adults conducted in 2009-2010. Clinical, metabolic, sociodemographic, and anthropometric data and information about lifestyle habits, such as physical activity, smoking habit, alcohol intake and food consumption, were collected. Subjects were classified according to their body mass index (BMI) (normal-weight, <25 kg/m(2); overweight, 25-29.9 kg/m(2); and obese, >30 kg/m(2)). CA included elevated blood pressure; elevated levels of triglycerides, fasting glucose, and high-sensitivity C-reactive protein (hs-CRP); and elevated homeostasis model assessment of insulin resistance (HOMA-IR) value and low high-density lipoprotein cholesterol (HDL-c) level. Two phenotypes were defined: metabolically healthy phenotype (0-1 CA) and metabolically abnormal phenotype (≥2 CA). The prevalence of metabolically abnormal normal-weight phenotype was slightly lower in the Spanish population (6.5% vs. 8.1%). The prevalence of metabolically healthy overweight and MHO subjects was 20.9% and 7.0%, respectively, while in NHANES study it was 17.9% and 9.7%, respectively. Cigarette smoking was associated with CA in each phenotype, while moderate physical activity and moderate alcohol intake were associated with being metabolically healthy. Olive oil intake was negatively associated with the prevalence of CA.

CONCLUSIONS

Smoking, physical activity level, and alcohol intake contribute to the explanation of the prevalence of CA in the Spanish population, as in the US population. However in Spain, olive oil intake contributes significantly to the explanation of the variance in the prevalence of CA.

Authors+Show Affiliations

Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain. Electronic address: gutierrezrepiso@gmail.com.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain.Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid, Madrid, Spain.Spanish Diabetes Society, Madrid, Spain.Public Health Division, Department of Health, Autonomous Government of Catalonia, Barcelona, Spain.Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain.Laboratorio de Endocrinología, Hospital Universitario San Carlos de Madrid, Madrid, Spain.Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Endocrinology and Diabetes Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), Universitat de Barcelona (UB), Barcelona, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Spain.Emergency Service, Hospital Nuestra Señora de los Reyes, Valverde, Tenerife, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain.Diabetes National Plan, Ministry of Health, Madrid, Spain.EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP - Fundació Jordi Gol), Barcelona, Spain.Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Lipids and Diabetes Laboratory, Instituto de Investigación Sanitaria del Hospital Clínico S. Carlos (IdISSC), Madrid, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Lipids and Diabetes Laboratory, Instituto de Investigación Sanitaria del Hospital Clínico S. Carlos (IdISSC), Madrid, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Department of Medicine and Endocrinology, Hospital Clínico Universitario de Valencia, Valencia, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Department of Medicine and Endocrinology, Hospital Clínico Universitario de Valencia, Valencia, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Endocrinology and Diabetes Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), Universitat de Barcelona (UB), Barcelona, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Biomedic Diagnostic Centre University Hospital Clínic de Barcelona, Barcelona, Spain.Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Spain.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24984822

Citation

Gutiérrez-Repiso, Carolina, et al. "Variable Patterns of Obesity and Cardiometabolic Phenotypes and Their Association With Lifestyle Factors in the Di@bet.es Study." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 24, no. 9, 2014, pp. 947-55.
Gutiérrez-Repiso C, Soriguer F, Rojo-Martínez G, et al. Variable patterns of obesity and cardiometabolic phenotypes and their association with lifestyle factors in the Di@bet.es study. Nutr Metab Cardiovasc Dis. 2014;24(9):947-55.
Gutiérrez-Repiso, C., Soriguer, F., Rojo-Martínez, G., García-Fuentes, E., Valdés, S., Goday, A., Calle-Pascual, A., López-Alba, A., Castell, C., Menéndez, E., Bordiú, E., Delgado, E., Ortega, E., Pascual-Manich, G., Urrutia, I., Mora-Peces, I., Vendrell, J., Vázquez, J. A., Franch, J., ... Gaztambide, S. (2014). Variable patterns of obesity and cardiometabolic phenotypes and their association with lifestyle factors in the Di@bet.es study. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 24(9), 947-55. https://doi.org/10.1016/j.numecd.2014.04.019
Gutiérrez-Repiso C, et al. Variable Patterns of Obesity and Cardiometabolic Phenotypes and Their Association With Lifestyle Factors in the Di@bet.es Study. Nutr Metab Cardiovasc Dis. 2014;24(9):947-55. PubMed PMID: 24984822.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Variable patterns of obesity and cardiometabolic phenotypes and their association with lifestyle factors in the Di@bet.es study. AU - Gutiérrez-Repiso,Carolina, AU - Soriguer,Federico, AU - Rojo-Martínez,Gemma, AU - García-Fuentes,Eduardo, AU - Valdés,Sergio, AU - Goday,Albert, AU - Calle-Pascual,Alfonso, AU - López-Alba,Alfonso, AU - Castell,Conxa, AU - Menéndez,Edelmiro, AU - Bordiú,Elena, AU - Delgado,Elías, AU - Ortega,Emilio, AU - Pascual-Manich,Gemma, AU - Urrutia,Inés, AU - Mora-Peces,Inmaculada, AU - Vendrell,Joan, AU - Vázquez,José Antonio, AU - Franch,Josep, AU - Girbés,Juan, AU - Castaño,Luis, AU - Serrano-Ríos,Manuel, AU - Martínez-Larrad,María Teresa, AU - Catalá,Miguel, AU - Carmena,Rafael, AU - Gomis,Ramón, AU - Casamitjana,Roser, AU - Gaztambide,Sonia, Y1 - 2014/06/09/ PY - 2013/11/29/received PY - 2014/04/29/revised PY - 2014/04/30/accepted PY - 2014/7/3/entrez PY - 2014/7/6/pubmed PY - 2015/5/12/medline KW - Metabolic risk factors KW - Metabolically abnormal normal-weight KW - Metabolically healthy obese KW - Prevalence rate KW - Spain SP - 947 EP - 55 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 24 IS - 9 N2 - BACKGROUND AND AIM: Prevalence rates of "metabolically healthy obese" (MHO) subjects vary depending on the criteria used. This study examined the prevalence and characteristics of MHO subjects and metabolically abnormal normal-weight subjects and compared the findings with the NHANES 1999-2004 study. The aims of the present study were, first, to determine the prevalence rates of MHO and MNHNO subjects using the same criteria as those of the National Health and Nutrition Examination Survey (NHANES) (1999-2004) study, and second to compare the prevalence and correlates of obese subjects who are resistant to the development of adiposity-associated cardiometabolic abnormalities (CA) and normal-weight individuals who display cardiometabolic risk factor clustering between the Spanish and the US populations. METHODS AND RESULTS: Di@bet.es study is a national, cross-sectional population-based survey of 5728 adults conducted in 2009-2010. Clinical, metabolic, sociodemographic, and anthropometric data and information about lifestyle habits, such as physical activity, smoking habit, alcohol intake and food consumption, were collected. Subjects were classified according to their body mass index (BMI) (normal-weight, <25 kg/m(2); overweight, 25-29.9 kg/m(2); and obese, >30 kg/m(2)). CA included elevated blood pressure; elevated levels of triglycerides, fasting glucose, and high-sensitivity C-reactive protein (hs-CRP); and elevated homeostasis model assessment of insulin resistance (HOMA-IR) value and low high-density lipoprotein cholesterol (HDL-c) level. Two phenotypes were defined: metabolically healthy phenotype (0-1 CA) and metabolically abnormal phenotype (≥2 CA). The prevalence of metabolically abnormal normal-weight phenotype was slightly lower in the Spanish population (6.5% vs. 8.1%). The prevalence of metabolically healthy overweight and MHO subjects was 20.9% and 7.0%, respectively, while in NHANES study it was 17.9% and 9.7%, respectively. Cigarette smoking was associated with CA in each phenotype, while moderate physical activity and moderate alcohol intake were associated with being metabolically healthy. Olive oil intake was negatively associated with the prevalence of CA. CONCLUSIONS: Smoking, physical activity level, and alcohol intake contribute to the explanation of the prevalence of CA in the Spanish population, as in the US population. However in Spain, olive oil intake contributes significantly to the explanation of the variance in the prevalence of CA. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/24984822/Variable_patterns_of_obesity_and_cardiometabolic_phenotypes_and_their_association_with_lifestyle_factors_in_the_Di@bet_es_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(14)00192-6 DB - PRIME DP - Unbound Medicine ER -