medigraphic.com
ISSN 0188-9796 (Print)

2003, Number 1

<< Back Next >>

Rev Endocrinol Nutr 2003; 11 (1)

Metabolic factors of cardiovascular risk in mexican people with different body mass index

Vázquez C , Salinas OS, Gómez DRA, Rosso JMM, Jiménez VM, Argüero SR

Language: Spanish
References: 32
Page: 15-21
PDF size: 92.80 Kb.


ABSTRACT

Background: Obesity is frequently related to a high cardiovascular risk, we compared anthropometric and metabolic data from three groups of healthy Mexican people with different body mass index (BMI), and evaluate several risk factors. Methods: In a 75 g glucose oral tolerance test, glucose, insulin, peptide C, fibrinogen, uric acid, triglyceride and total, high and low density lipoprotein cholesterol were measured in fasting, 60 and 120 minutes blood samples. Group I (BMI < 25, n = 187), group II (BMI 25-26.9, n = 103) and group III (BMI > 27 kg/m2, n = 198), were compared with ANOVA, Student t and Mann-Whitney U tests, adjustments by age, sex and waist to hip ratio (WHR) were made. Results: Significative differences (p < 0.05) were found between each BMI groups in weight, WHR, blood pressure, glucose, insulin, peptide C, fibrinogen, triglycerides and glucose/insulin ratio (GIR); all of them increased as BMI did. Positive correlations were found between BMI, blood pressure, glucose and insulin (r = 0.20) and a negative one with GIR (r = -0.31) and HDL-C (r = -0.23). Most people with high levels of lipids, fibrinogen uric acid and lower levels of HDL-C belonged to the highest BMI group. Conclusions: Metabolic alterations frequently related to obesity were present even in subjects with a BMI of 25 kg/m2, more notorious as the BMI increased, prevention strategies for obesity therefore should start earlier in our population.


REFERENCES

  1. National Institutes Consensus Development Panel on the Health Implications of Obesity. Consensus Conference Statement. Ann Intern Med 1985; 103: 1073-7.

  2. Everson SA, Goldberg DE, Helmrich SP, Lakka TA, Lynch JW, Kaplan GA, Salonen JT. Weight gain and the risk of developing insulin resistance syndrome. Diabetes Care 1998; 21: 1637-1643.

  3. Manicardi V, Camellini L, Belludi G, Coscelli C, Ferrannini E. Evidence for an association of high blood pressure and hyperinsulinaemia in obese man. J Clin Endocrinol Metab 1986; 62: 1302-4.

  4. Golditz GA, Willet WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Inter Med 1995; 122: 481-6.

  5. Després JP. Dyslipidaemia and obesity. Bailliere´s Clin Endocrinol Metab 1994; 8(3): 629-660.

  6. Bray GA. Complications of obesity. Ann Inter Med 1985; 103: 1052-1062.

  7. Fontbonné A, Charles MA, Thibult N, Richards JL, Claude JR, Warnet JM, Rosselin GE, Eschwege E. Hyperinsulinaemia as a predictor of coronary heart disease mortality in a healthy population. The Paris Prospective Study, 15-year follow-up. Diabetologia 1991; 34: 356-361.

  8. Felson DT. Weight and osteoarthitis. Am J Clin Nutr 1996; 63: 430S-4432S.

  9. Grunstein RR, Wilcox I. Sleep-disordered breathing and obesity. Bailliere´s Clin Endocrinol Metab 1994; 8(3): 601-628).

  10. Everhart JE. Contributions of obesity and weight loss to gallstone disease. Ann Intern Med 1993; 119: 1029-1035.

  11. Hagen J, Deitel M, Khanna RK et al. Gastroesophageal reflux in the massively obese. Int Surg 1987; 72: 1-3.

  12. Golditz GA. Economic costs of obesity. Am J Clin Nutr 1992; 55: 503S-507S.

  13. Jung RT, Chong P. Current therapy: the management of obesity. Clin Endoc 1991; 35: 11-20.

  14. World Health Organization. Obesity: Preventive and managing the global epidemic. Report of a WHO consultation on obesity. Geneva 1997: 1-276.

  15. Guidance for treatment of adult obesity. American Obesity Association. 1996.

  16. XI Censo General de Población y Vivienda. Instituto Nacional de Estadística, Geografía e Informática. México 1990.

  17. Encuesta Nacional de Enfermedades Crónicas. Secretaría de Salud 1993, Segunda edición, México 1995.

  18. American Medial Association. Ejecutive summary of the third reported of the National Cholesterol Education Program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult treatment panel III). JAMA 2001; 285: 2486-2497.

  19. Caro JF. Clinical Review: Insulin resistance in obese and non obese man. J Clin Endocrinol Metab 1991; 73(4): 691-5.

  20. Pi-Sunyer FX, La Ferrere B, Aronne LJ, Bray GA. Therapeutic controversy: Obesity-A modern day epidemic. J Clin Endocrinol Metab 1998; 84(1): 3-12.

  21. Obesidad en México. Funsalud/Universidad de Yucatán, México 1999.

  22. Gottdiener RS, Reda AJ, Materson BJ et al. Importance of obesity, race and age to the cardiac structural and functional effects of hypertension. J Am Coll Cardiol 1994; 24: 1492-8.

  23. Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysis of the insulin resistance syndrome (Syndrome X). Diabetes 1992; 41: 715-722.

  24. Tchernof A, Labrie F, Belanger A, Prud´homme Bouchard C, Tremblay A, Nadeau A, Després JP. Relationships between endogenous steroid hormone, sex hormone-binding globulin and lipoprotein levels in men: contribution of visceral obesity, insulin levels and other metabolic variables. Atherosclerosis 1997; 133: 235-244.

  25. Folsom AR, Skylo M, Stevens J, Liau F, Smith R, Eckfeldt JH. A prospective study of coronary heart disease in relation to fastin insulin, glucose and diabetes. The Atherosclerosis Risk in Communities ARIC) Study. Diabetes Care 1998; 20: 935-942.

  26. Bray GA. Obesity: Basic aspects and clinical implications. Med Clin North Am 1989; 73: 1-264.

  27. Haffner SM, Miettinen H, Gaskill SP, Stern MP. Decreased insulin secretion and increased insulin resistance are independently realted to the 7-year risk of NIDDM in Mexican-American. Diabetes 1995; 49: 1386-1391.

  28. Manson JE, Willet WC, Stampfer MJ et al. Body weight and mortality among women. N Engl J Med 1995; 333: 677-685.

  29. Stevens J, Cai j, Pamuk ER, Williamson DF, Thun MJ, Wood JI. The effect of age and the association between body mass index and mortality. N Engl J Med 1998; 338: 1-7.

  30. Rösner S. Defining success in obesity management. Int J Obes 1997; 21(Suppl.1): 52-54.

  31. Nabulisi AA et al. ARIC The Atherosclerosis Risk in Communities Study. Metabolism 1995; 44: 914-922.

  32. Quesenberry Jr CP, Caan B, Jaconson A. Obesity, health services use and care costs among members of a health maintenance organization. Arch Intern Med 1998; 158: 466-472.




2020     |     www.medigraphic.com