Altitude and its inverse association with abdominal obesity in an Andean country: a cross-sectional study

Abstract

Background: Abdominal obesity represents an accurate predictor of overall morbidity and mortality, which is worrisome because it is also continuously increasing across Andean countries. However, its relationship with altitude remains unclear. The objective of this study was to assess the association between altitude and abdominal obesity in Peru, and how sociodemographic variables impact this association. Methods: We estimated the prevalence of abdominal obesity in Peru and analyzed its association with altitude using the data from the 2012-2013 National Household Survey (ENAHO). During this survey, a representative sample of Peruvians was screened for abdominal obesity, using waist circumference as a proxy, and the Adult Treatment Panel III guidelines cutoffs. Results: Data were analyzed from a sample of 20 489 Peruvians (51% male). The prevalence of abdominal obesity was estimated at 33.6% (95% CI: 32.5 to 34.6%). In Peru, altitude was significantly and inversely associated with abdominal obesity, decreasing with higher altitudes: 1500-2999 meters above mean sea level (MAMSL) vs <1500 MAMSL, adjusted prevalence rate [aPR]= 0.90 (95% CI: 0.84 to 0.96); ≥3000 MAMSL vs <1500 MAMSL, aPR= 0.78 (95% CI: 0.72 to 0.84), when adjusting by age, gender and residence area (rural/urban). However, this association was significantly modified by age and gender (p< 0.001). Conclusion: Abdominal obesity is highly prevalent in Peru and decreases significantly with altitude, but age and gender modify this association. Thus, abdominal obesity appears to affect older women from low altitudes more than younger men from high altitudes.

Socioeconomic inequalities in abdominal obesity among Peruvian adults

“…In high-income countries such as the United States and Portugal, the prevalence of AO reaches 57.2% [4] and 50.5% [5] respectively, being even higher in upper-middleincome countries such as Mexico where it reaches 74.0% [6]. Using the International Diabetes Federation (IDF) cut-off points, the prevalence of AO in Peru in 2013 was 64.1% [7]. This disease threatens to overload the economic and resolutive capacity of health systems, particularly in Latin American countries in which budgets assigned to health are very limited, being of around 7.9% of the Gross Domestic Product (GDP) in 2018 compared to 16.9% in the United States [8].…”

Altitude and its inverse association with abdominal obesity in an Andean country: a cross-sectional study

“…We analyzed a population sample of 20,489 subjects from 703 different locations across 25 administrative regions of Peru. To summarize population demographics, most subjects were either female (51.6%), adults between 20 to 39 years of age (39.8%), or inhabitants from urban areas (79.6%) 22 . Of these three demographic measures, both age groups ( p =0.0006) and area of residence ( p <0.0001) distribution varied significantly by altitude ( Table 1).…”

“…Figshare: Altitude and its inverse association with abdominal obesity in an Andean country. https://doi.org/10.6084/m9.figshare.9920234.v1 22…”

Association between Altitude and the Framingham Risk Score: A Cross-Sectional Study in the Peruvian Adult Population

“…According to the biomedical literature, altitude is a factor associated with CVD and has an inverse association with cardiovascular risk factors [ 10 , 11 , 12 , 13 , 14 ] and mortality associated with CVD [ 15 ]; however, the exposure time necessary to obtain a cardioprotective effect is not clear. In this regard, long-term exposure to hypobaric hypoxia (in high altitude regions) could be associated with a lower incidence of obesity, arterial hypertension, metabolic syndrome, and diabetes in individuals due to complex interactions between behavioral and environmental conditions [ 10 , 11 , 12 , 13 ]. In Peru (one of the countries belonging to the Andean region of South America), high altitude regions are associated with rural areas and are mostly located at 2500 m above sea level (masl) [ 16 ].…”