RESUMO
OBJECTIVE: In this study we examine the association between body mass index and a wide range of metabolic coronary heart disease risk factors in a female population of South Italy. DESIGN: Observational study named "VIP Project" divided in three phases: collection of data, follow-up of the population and new controls within five and ten years. Data presented are about the transversal phase of the study. SUBJECTS: 1200, 600 males and 600 females, age ranging from 25 to 74 years, were enrolled at random from the electoral lists of the towns of Mercato San Severino and Baronissi, near Salerno, in Southern Italy. MEASUREMENTS: Weight (electronic scale), height (ruler attached to the wall), blood pressure (sphygmomanometer), fasting venous blood to determine: total cholesterol, HDL and LDL cholesterol, triglycerides, uric acid, blood glucose, haemocrome, insulinaemia, fibrinogen, C3 and creatinine. Smoking habit and the practice of sports were determined by an interview. RESULTS: The distribution of BMI in the population, increases with reference to the age. Between BMI and the classical risk factors, there is a significant correlation with triglycerides, glycaemia, total cholesterol, diastolic blood pressure, systolic blood pressure, insulin, C3. In the decades from 35-44 years to 45-54 years, it can be observed a notable increasing of the following risk factors in percentage for female population: hypertriglyceridemia from 3.9% to 33.9%, diabetes from 4.4% to 10.2%, hypertension from 9.1% to 25.8%, obesity from 22.5% to 42.5% and hypercholesterolaemia from 3.6% to 25%. Only the number of smokers is decreasing from 38.3% to 19.2%. CONCLUSION: The association between body mass index and increasing coronary heart disease risk in women is partly explained by a rise in blood pressure, lipid profile and blood glucose across the range of body mass index. Most approaches to weight loss recommend a target or optimal weight based on body mass index alone. Our data show that this assumption is unwarranted and that body mass index should not be used as the sole basis for intervention in individuals. Successful weight loss should be defined in terms of a reduction in metabolic risk, which can often be achieved by relatively modest weight loss.
