Abstract MP80: Higher Central Fat, Longer Obesity Duration are Independently Associated with Cardiometabolic Risk Phenotypes in Normal Weight and Obese Adults: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Introduction: Within BMI categories, there are distinct phenotypes based on cardiometabolic risk. Normal weight (BMI 18.5-24.9 kg/m2) and obese (BMI ≥30 kg/m2) adults can be defined as either metabolically healthy (MH), having all favorable risk factor levels (defined in Table), or metabolically abnormal (MA), having ≥1 unfavorable risk factor. We hypothesized that trunk fat and weight history, i.e., obesity duration and changes in BMI and waist circumference (WC) would be correlates of these phenotypes.
Methods: Black and white adults from the CARDIA Study had anthropometric and clinical measures assessed at 7 exams over 20 years and % fat in trunk assessed by DXA at the Year 20 exam. BMI category and cardiometabolic risk status were assessed at Year 20, at ages 38-50. Changes in BMI and WC were calculated as difference between baseline and Year 20 measures. Years of obesity duration were calculated based on number of years obese from baseline to Year 20. In cross-sectional analyses within each BMI stratum, characteristics were compared between MH and MA phenotypes; multivariable logistic regression was used to estimate odds of having the MA phenotype.
Results: Prevalence of MH phenotype was 45% (411/914) in normal weight adults and 9% (125/1399) in obese adults. In normal weight and obese adults, MH had lower BMI, smaller WC, smaller changes in WC, and higher % trunk fat compared with MA. With multivariable adjustment higher % trunk fat was associated with greater odds of the MA phenotype in normal weight and obese. In obese adults, activity was inversely associated with MA; changes in WC, % trunk fat, and obesity duration were associated with the MA phenotype (Table).
Conclusion: % trunk fat is a correlate of the MA phenotype in normal weight and obese adults. Activity, changes in WC, and obesity duration are correlates of the MA phenotype in obese adults. These findings support prior reports of activity and central fat as correlates of cardiometabolic risk and suggest obesity duration as an additional correlate.
- © 2013 by American Heart Association, Inc.