Obesity phenotypes in urban and rural Cameroonians: a cross-sectional study

Abstract

BackgroundDespite the increasing prevalence of diabetes and other health consequences of obesity, little is known on the metabolic profile across categories of body mass index (BMI) among African populations. We therefore assessed the prevalence and distribution of body size phenotypes among urban and rural Cameroonians.MethodsAdults (n = 1628; 41% rural dwellers) aged 24–74 years in 1994 provided data on BMI and metabolic health, defined on the basis of elevated levels of blood pressure (BP); triglycerides, fasting plasma glucose (FPG), and insulin resistance as assessed with homeostasis model assessment (HOMA). Cross-classification of BMI categories and metabolic status (healthy/unhealthy) created six groups. Metabolic measures include elevated blood pressure; elevated triglycerides (≥150 mg/dL or 1.69mmo/L), elevated fasting plasma glucose (≥100 mg/dl or 5.6 mmol/L or documented use of antidiabetic medications), and elevated homeostasis model assessment of insulin resistance value (HOMA-IR > 90th percentile).ResultsA total of 25.2% of participants were overweight yet metabolically healthy (<1 abnormality) and 10.1% were obese yet metabolically healthy, whereas 1.4% were normal weight but metabolically abnormal (≥2 abnormalities). Proportion of rural dwellers with abnormal metabolic phenotype across normal-weight, overweight, obese categories were 2.9%, 0.8% and 0.3%, respectively; and 0 .3%, 2.2% and 2.6% among urban dwellers. Metabolically abnormal participants increased linearly across BMI categories (p < 0.001). BMI categories and metabolic status interacted to affect age, gender, BMI, FPG, triglycerides, and BP status distributions (all p < 0.04). Metabolic status and residence (rural vs. urban) interacted to influence the distribution across BMI categories of diastolic BP, BMI, waist circumference, fasting and 2-hour glucose, triglycerides, HOMA-IR, and prevalent diabetes (all p < 0.005), with differential occurrence of BMI categories and metabolic status among urban and rural participants.ConclusionsMetabolic healthy obesity and obesity with a favorable cardiometabolic profile are not uncommon among Cameroonians, including among rural dwellers; but the latter group tended to have a better profile.

Body mass index–measured adiposity and population attributability of associated factors: a population-based study from Buea, Cameroon

“…These findings suggest an increasing trend in overweight and obesity in Cameroon, as previous reports in Cameroon showed just over a quarter of the population was overweight [34, 35]. Our findings are similar to reports of a recent systematic review from Nigeria which found rates of 20–35% and 8.1–22% for overweight and obesity respectively [36].…”

“…Furthermore, an overall tendency to overweight was observed in our study population (mean BMI of 25.3 kg/m 2 ). This was marginally higher than previously reported in Cameroon [34, 35]. While the variance may not be striking, it should be noted that the majority of our study population was made up of young adults, almost a decade younger than previous reports in Cameroon [34].…”

“…This was marginally higher than previously reported in Cameroon [34, 35]. While the variance may not be striking, it should be noted that the majority of our study population was made up of young adults, almost a decade younger than previous reports in Cameroon [34]. This suggests an expansion (including younger people) in the burden of overweight and obesity and consequently an increased risk of NCDs in the younger population.…”

Distribution of obesity phenotypes and in a population-based sample of Iranian adults

“…Obesity is associated with an altered metabolic profile, and is a major risk factor for type 2 diabetes mellitus and other cardiovascular disease (CVD) risk factors including hypertension, dyslipidemia and pro-inflammatory states [1]. About 52% of the worldwide adult population is either overweight or obese [2].…”

“…A further 'obesity' phenotype includes individuals of normal weight, who have metabolic abnormalities, commonly found in overweight and obese individuals [1,3]. Concepts such as "metabolically healthy" and "metabolically abnormal" have been used to characterize individuals across the distribution of body mass index (BMI) as a function of the underlying burden of metabolic abnormalities.…”