Abstract P256: Why BMI is not Enough: Prevalence of Metabolically Obese Normal Weight in the CARDIAC Project
Recent evidence suggest the presence of normal weight adolescents (as defined by BMI percentiles <85th) in the general population who present a clustering of metabolic abnormalities (MetS), commonly observed in the overweight and obese, which predispose them to cardiovascular disease and diabetes. MetS is generally defined as including insulin resistance, high low-density lipoproteins (LDL), low high-density lipoproteins (HDL), high triglycerides (TRIG), high systolic (SBP) and/or diastolic blood pressure (DBP). The goal of this study was to establish the prevalence of metabolically obese normal weight (MONW) children in a rural Appalachian.
Methods: Data included 43,432 5th grade students from the 2002-2011 Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) project. MetS included risk levels for LDL, HDL, TRIG, SBP, and acanthosis nigricans (AN) as a measure of insulin resistance.
Results: 22,331 (51.42%) were normal weight. Among those, 23.61% had at least one metabolic abnormality, 5.50% had two, 0.75% had three and 0.03% had four. Figure 1 shows frequencies of MetS and normal weight and overweight/obese participants. The odds of MetS were greater in those who were overweight or obese; however, of the 2,407 participants who had MetS when defined as 3 or more risk factors, 7.19% were of normal weight. Of the 8,336 participants who had MetS when defined as 2 or more risk factors, 16.18% were of normal weight.
We also explored gender differences among all students (n = 43,432). After controlling for weight status, being female was a risk factor for MetSyn diagnosis when defined as 2 or more (OR = 1.53) or 3 or more (OR = 1.34) risk factors.
Conclusion: This data adds to the emerging literature aimed towards unifying a definition of metabolic syndrome in children and suggest that definitions should include considerations for all weight categories. In addition, because BMI poorly distinguishes between lean and fatty mass, measures of obesity should include a measurement of adiposity, such as waist circumference.
- © 2013 by American Heart Association, Inc.