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Gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study

BACKGROUND: Beyond the degree of adiposity, the pattern of fat distribution has a profound influence on cardiometabolic risk. It is unclear if sex differences in body fat distribution can potentially explain any sex differences in the prevalence of the metabolic syndrome (MetS) and in individual car...

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Autores principales: Strack, Christina, Behrens, Gundula, Sag, Sabine, Mohr, Margareta, Zeller, Judith, Lahmann, Claas, Hubauer, Ute, Loew, Thomas, Maier, Lars, Fischer, Marcus, Baessler, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8897897/
https://www.ncbi.nlm.nih.gov/pubmed/35246259
http://dx.doi.org/10.1186/s13293-022-00416-4
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author Strack, Christina
Behrens, Gundula
Sag, Sabine
Mohr, Margareta
Zeller, Judith
Lahmann, Claas
Hubauer, Ute
Loew, Thomas
Maier, Lars
Fischer, Marcus
Baessler, Andrea
author_facet Strack, Christina
Behrens, Gundula
Sag, Sabine
Mohr, Margareta
Zeller, Judith
Lahmann, Claas
Hubauer, Ute
Loew, Thomas
Maier, Lars
Fischer, Marcus
Baessler, Andrea
author_sort Strack, Christina
collection PubMed
description BACKGROUND: Beyond the degree of adiposity, the pattern of fat distribution has a profound influence on cardiometabolic risk. It is unclear if sex differences in body fat distribution can potentially explain any sex differences in the prevalence of the metabolic syndrome (MetS) and in individual cardiometabolic risk factors among obese men and women. METHODS: In this cross-sectional analysis, 432 persons from the ongoing Obesity Weight Reduction Study (n = 356 obese, ØBMI 41 ± 8 kg/m(2), and 76 non-obese, ØBMI 25 ± 3 kg/m(2)), were included. The relations of sex to MetS prevalence and selected cardiometabolic risk factors were assessed using univariate and multivariate adjusted regression models. RESULTS: In crude analyses, %fat mass and the fat mass/lean mass ratio were significantly higher in women than in men, regardless of increasing obesity categories, from normal weight to grade-3-obesity. In contrast, markers of abdominal obesity, such as waist circumference and waist-to-hip ratio were higher in men than in women, despite similar BMI. The prevalence of the MetS was higher in obese men than in women (67.6 vs. 45.0%, p < 0.0001), particularly in younger individuals < 40 years (72.5 vs. 36.8%, p < 0.0001), but “metabolically healthy obesity” (BMI ≥ 30, no other NCEP ATPIII MetS component) was more common in women than in men (15.6 vs. 4.1%, p < 0.0001). After adjusting for age, %body fat and height, sex differences were observed for HDL-cholesterol (p < 0.001), triglycerides (p < 0.001), fasting glucose (p = 0.002), insulin and HOMA-IR levels (p < 0.001), ALAT (p < 0.001), adiponectin (p < 0.001), and sE-selectin (p = 0.005). In contrast, crude sex differences in other variables, such as leptin levels (68 ± 4 in obese women vs. 33 ± 2 µg/L in men, p < 0.0001), disappeared after accounting for differences in %body fat (least-squares means of leptin: 52 ± 4 vs. 55 ± 6 µg /L, p = 0.740). A logistic regression model adjusting for age and lifestyle factors revealed a lower risk of having MetS for women as compared to men (OR = 0.38[0.22–0.60]). That risk estimate did not materially alter after adding BMI to the model. In contrast, no statistically significant association between sex and MetS prevalence was observed after adding waist circumference and adiponectin to the model (OR = 1.41[0.59–3.36]). CONCLUSIONS: Different body fat distribution patterns, particularly abdominal adiposity, adiponectin, and related biomarkers, may contribute to sex differences in cardiometabolic risk factors and to the prevalence of the MetS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13293-022-00416-4.
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spelling pubmed-88978972022-03-14 Gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study Strack, Christina Behrens, Gundula Sag, Sabine Mohr, Margareta Zeller, Judith Lahmann, Claas Hubauer, Ute Loew, Thomas Maier, Lars Fischer, Marcus Baessler, Andrea Biol Sex Differ Research BACKGROUND: Beyond the degree of adiposity, the pattern of fat distribution has a profound influence on cardiometabolic risk. It is unclear if sex differences in body fat distribution can potentially explain any sex differences in the prevalence of the metabolic syndrome (MetS) and in individual cardiometabolic risk factors among obese men and women. METHODS: In this cross-sectional analysis, 432 persons from the ongoing Obesity Weight Reduction Study (n = 356 obese, ØBMI 41 ± 8 kg/m(2), and 76 non-obese, ØBMI 25 ± 3 kg/m(2)), were included. The relations of sex to MetS prevalence and selected cardiometabolic risk factors were assessed using univariate and multivariate adjusted regression models. RESULTS: In crude analyses, %fat mass and the fat mass/lean mass ratio were significantly higher in women than in men, regardless of increasing obesity categories, from normal weight to grade-3-obesity. In contrast, markers of abdominal obesity, such as waist circumference and waist-to-hip ratio were higher in men than in women, despite similar BMI. The prevalence of the MetS was higher in obese men than in women (67.6 vs. 45.0%, p < 0.0001), particularly in younger individuals < 40 years (72.5 vs. 36.8%, p < 0.0001), but “metabolically healthy obesity” (BMI ≥ 30, no other NCEP ATPIII MetS component) was more common in women than in men (15.6 vs. 4.1%, p < 0.0001). After adjusting for age, %body fat and height, sex differences were observed for HDL-cholesterol (p < 0.001), triglycerides (p < 0.001), fasting glucose (p = 0.002), insulin and HOMA-IR levels (p < 0.001), ALAT (p < 0.001), adiponectin (p < 0.001), and sE-selectin (p = 0.005). In contrast, crude sex differences in other variables, such as leptin levels (68 ± 4 in obese women vs. 33 ± 2 µg/L in men, p < 0.0001), disappeared after accounting for differences in %body fat (least-squares means of leptin: 52 ± 4 vs. 55 ± 6 µg /L, p = 0.740). A logistic regression model adjusting for age and lifestyle factors revealed a lower risk of having MetS for women as compared to men (OR = 0.38[0.22–0.60]). That risk estimate did not materially alter after adding BMI to the model. In contrast, no statistically significant association between sex and MetS prevalence was observed after adding waist circumference and adiponectin to the model (OR = 1.41[0.59–3.36]). CONCLUSIONS: Different body fat distribution patterns, particularly abdominal adiposity, adiponectin, and related biomarkers, may contribute to sex differences in cardiometabolic risk factors and to the prevalence of the MetS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13293-022-00416-4. BioMed Central 2022-03-04 /pmc/articles/PMC8897897/ /pubmed/35246259 http://dx.doi.org/10.1186/s13293-022-00416-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Strack, Christina
Behrens, Gundula
Sag, Sabine
Mohr, Margareta
Zeller, Judith
Lahmann, Claas
Hubauer, Ute
Loew, Thomas
Maier, Lars
Fischer, Marcus
Baessler, Andrea
Gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study
title Gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study
title_full Gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study
title_fullStr Gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study
title_full_unstemmed Gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study
title_short Gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study
title_sort gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8897897/
https://www.ncbi.nlm.nih.gov/pubmed/35246259
http://dx.doi.org/10.1186/s13293-022-00416-4
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