The Association between Cardio-metabolic and hepatic indices and anthropometric measures with metabolically obesity phenotypes: a cross-sectional study from the Hoveyzeh Cohort Study

Abstract

Background This study aimed to compare the cardio-metabolic, anthropometric, and liver function indices among metabolic obesity phenotypes. Methods In this cross-sectional study, which was carried out in Hoveyzeh, Khuzestan Province, Iran, a total of 7,464 individuals (male: 2859, female: 4605), were recruited and classified into four groups, based on Body Mass Index (obese, BMI ≥ 30 kg/m2; non-obese, BMI = 18.5–29.9 kg/m2) and the National Cholesterol Education Program and Adult Treatment Panel (NCEP ATP) III criteria (Healthy group, ≤ 1 of the criteria; Unhealthy group, ≥ 2 of the criteria), as follows: Metabolically Healthy Non-Obese (MHNO, 28.14%), Metabolically Unhealthy Non-Obese (MUNO, 33.06%), Metabolically Healthy Obese (MHO, 6.54%), and Metabolically Unhealthy Obese (MUO, 32.26%). Anthropometric indices (Waist/Hip Ratio (WHR), Waist/Height Ratio (WHtR), Body Adiposity Index (BAI), Visceral Adiposity Index (VAI), and Weight adjusted Waist Index (WWI)), cardio-metabolic indices (Atherogenic Index of Plasma (AIP), Lipid Accumulation Product (LAP), Cardio-Metabolic Index (CMI), Lipoprotein Combine Index (LCI), Triglyceride-Glucose (TyG), TyG-BMI, TyG-WC, and Thrombolysis In Myocardial Infarction (TIMI) risk index), and hepatic indices (Hepatic Steatosis Index (HSI) and ALD/NAFLD index (ANI)) were calculated and compared between the groups. Results WHR,VAI, AIP, LAP, CMI, LCI, TyG, and TIMI risk index values were significantly higher in the MUNO phenotype compared to the MHO phenotype (WHR: 0.97 vs. 0.95; VAI: 3.16 vs. 1.33; AIP: 0.58 vs. 0.25; LAP: 78.87 vs. 55.79; CMI: 2.69 vs. 1.25; LCI: 27.91 vs. 12.11; TyG: 9.21 vs. 8.41; TIMI: 18.66 vs. 15.63; p < 0.001). The highest and lowest HSI and ANI values were detected in the MUO phenotype. After adjustment for age, sex, physical activity, and years of education, VAI showed the highest Odds Ratio for MUNO (OR: 5.65; 95% CI: 5.12, 6.24) and MUO (OR: 5.40; 95% CI: 5.89, 5.95) compared to the MHNO phenotypes (p < 0.001). The ANI indices was associated with a reduced risk of MUO (OR: 0.76; 95% CI: 0.75–0.78), MUNO (OR: 0.88; 95% CI: 0.87–0.90), and MHO (OR: 0.79; 95% CI: 0.77–0.81) phenotypes (p < 0.001). Conclusion MUNO phenotype was exposed to a higher risk of cardiovascular disease compared to the MHO phenotype. VAI was found to be the optimal index for cardiovascular risk assessment.

Association between cardiometabolic phenotypes with atherogenic index of plasma: a cross-sectional study from the Azar Cohort Study

“…The large odds ratio for MUHNW may be due to the small sample size of this phenotype. The results of this study are consistent with the findings of ZakerKish et al, Sadeghi et al In Iran, Tan et al in China and several other studies (23,30,35) . Previous studies have shown that individuals with higher AIP values are more likely to develop hypertension, dyslipidemia, metabolic syndrome, and cardiovascular disease (CVD) (36)(37)(38).…”

“…These values were significantly higher than the average AIP in the MHNW and MHO groups, highlighting the elevated cardiovascular risk associated with metabolic unhealthiness regardless of obesity status (29). These findings align with those reported by Zakerkish et al and Abdolnezhadian et al, reinforcing the utility of AIP as a reliable marker for identifying individuals at higher risk for cardiovascular diseases (30,31). The significant differences in AIP among the phenotypes underscore its importance in evaluating cardiometabolic health (32,33).…”

NAFLD is a predictor of high risk of development and a co-factor in the progression of cardiovascular diseases

“…патофизиология нАжбп, прежде всего, тесно связана с метаболическим синдромом, кластером факторов риска сердечно-сосудистых заболеваний. однако пациенты с нАжбп без избыточного веса/ ожирения (нАжбп худых [32]) также имеют высокие шансы отклонений в метаболическом профиле с одной стороны, а с другой -высокий риск сердечно-сосудистых заболеваний и неблагоприятного сердечнососудистого прогноза по сравнению с пациентами с «метаболически здоровым» фенотипом ожирения [33]. накопление висцерального жира в печени и миокардиально (внутри и вокруг ткани миокарда) сопровождается формированием системного воспалительного синдрома, высвобождением провоспалительных адипоцитокинов, вызывающих дисфункцию микроциркуляторного русла и фиброз прилегающего миокарда, что также может приводить к развитию фибрилляции предсердий и сердечной недостаточности с сохранённой фракцией выброса, а воспалительные изменения в левом предсердии -к электроанатомическому ремоделированию [34,35].…”