ABSTRACT
<p><b>Background</b>Obesity induces dyslipidemia, hypertension, glucose intolerance, and inflammatory state, which results in atherogenic processes, diabetes, and cardiovascular disease. We usually use body composition indices, such as body mass index (BMI), body fat percentage (BFP), waist circumference-height ratio (WHtR), and waist-hip ratio (WHR) to reflect the obesity. The aim of this large population-based cross-sectional study was to investigate the associations between body composition indices and metabolic parameters in Chinese adults.</p><p><b>Methods</b>A total of 12,018 Chinese adults were included. Body composition indices, such as BMI, BFP, WHtR, and WHR, and metabolic parameters, such as systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), fasting blood glucose (FBG), 2 h postprandial blood glucose (2h PBG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS), insulin resistance index (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP), and white blood cell count (WBC), were measured and analyzed. All analyses were stratified by gender.</p><p><b>Results</b>All body composition indices and metabolic parameters except 2h PBG differed significantly between males and females (all P < 0.001). BMI was positively associated with SBP, DBP, LDL-C, TC, TG, FBG, 2h PBG, HbA1c, FINS, HOMA-IR, hs-CRP, and WBC, and inversely associated with HDL-C; similar relationships were identified between the metabolic parameters and BFP, WHtR, and WHR. In the multivariate analysis, the odds of impaired glucose regulation, dyslipidemia, insulin resistance, and increased hs-CRP were 1.36, 1.92, 3.44, and 1.27 times greater in the overweight group than those in the normal weight group, respectively, and 1.66, 3.26, 7.53, and 1.70 times greater in the obese group than those in the normal weight group, respectively. The odds of dyslipidemia and hs-CRP were 1.29 and 1.38 times greater in the BFP ≥28.0% group than in the BFP <28.0% group, respectively. The odds of dyslipidemia, HOMA-IR, and hs-CRP were 1.55, 1.26, and 1.48 times greater in the WHtR ≥0.96 group than in the WHtR <0.96 group, respectively. Among males, the odds of HOMA-IR were 1.46 times greater in the WHR ≥0.54 group than in the WHR <0.54 group. Similar results were observed in females.</p><p><b>Conclusions</b>This study identified positive associations between all evaluated body composition indices and metabolic parameters in Chinese adults. Among the body composition indices, BMI predicted four of the five evaluated metabolic disorders in both gender groups.</p>
ABSTRACT
Objective To evaluate the effect of obesity on long-term prognosis in patients with acute coronary syndrome (ACS) but without diabetes. Methods A total of 571 patients with ACS but without diabetes were included in a retrospective study. The patients were categorized as normal, overweight, and obese groups based on body mass index (BMI) levels. The mean follow-up time was 3 years. The ultimate events were major adverse cardiovascular events (MACE), including primary ultimate events (sudden cardiac death and non-fatal myocardial infarction) and rehospitalization with unstable angina. Results The incidence of long-term MACE was 33.6%, and it decreased with the increase in BMI levels (P trend=0.031). Obese patients had a lower risk of MACE than their normal weight counterparts (HR=0.58; 95% CI, 0.37-0.91; P=0.016). After multivariable adjustment, the lower risk of MACE in obese patients remained significant (HR=0.60; 95% CI, 0.39-0.94; P=0.027). Conclusions In a population with ACS but without diabetes, obese patients had a decreased risk of cardiovascular events compared with normal weight patients. In concordance with the data in patients with diabetes or coronary heart disease, the present study has further suggested that obesity may play a protective effect on long-term prognosis in patients with ACS but without diabetes.