2011, Number 2
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Cir Cir 2011; 79 (2)
Impact of waist circumference reduction in cardiovascular risk in obese subjects treated
Fanghänel G, Sánchez-Reyes L, Félix-García L, Violante-Ortiz R, Campos-Franco E, Antonio Alcocer L
Language: Spanish
References: 26
Page: 175-181
PDF size: 280.87 Kb.
ABSTRACT
Background: The World Health Organization reports that waist circumference (WC) independent of weight or body mass index (BMI) predicts cardiovascular risk. We undertook this study to determine the change of prevalence in comorbidities associated with obesity and cardiovascular risk after favorably modifying WC.
Methods: We studied 153 nondiabetic patients with obesity (BMI ≥30 kg/m2) and WC in women ≥80 cm and in men ≥94 cm who entered a weight control program for 2 years. We evaluated the evolution of their anthropometric measurements and metabolic status. Ninety patients (58.8%) completed the study. With the prior acceptance of the patients, they received nutritional advice and psychological and physical activity support during their monthly visits. Also, anthropometric measurements and blood pressure were evaluated. At the beginning and after each 6 months, glucose, total cholesterol, HDL cholesterol and triglycerides were determined. At the beginning and at the end of study the Framingham risks were evaluated.
Results: Of the 90 patients, 37 (group 1) decreased their WC: in women ‹80 cm and in men ‹94 cm. In 53 patients (group 2) there were no significant changes. Changes were shown in group 1 for blood pressure (from 36.6% to 21.6%), hyperglycemia ›100 mg/dl creased from 18.8% to 8.1%, triglycerides ›150 mg/dl decreased from 28.8% to 18.9% and Framingham risk at 10 years decreased.
Conclusions: There is a direct relationship between WC and cardiovascular risk. When WC decreases, cardiovascular risk is favorably modified. Measurement of WC is a good predictor of cardiovascular risk.
REFERENCES
Barquera S, Campos-Nonato I, Hernández-Barrera L, Flores M, Durazo-Arvizu R, Rivera J. Obesity and central adiposity in Mexican adults: results from the Mexican Health and Nutrition Survey 2006. Salud Publica Mex 2009;51(suppl 4):S540-S550.
National Institutes of Health. Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: the evidence report. Obes Res 1998;suppl 2:51S-209S.
Kuczmarski RJ, Fegal KM, Campbell SM, Johnson CL. Increasing prevalence of overweight among US adults: The National Health and Nutrition Examination Survey, 1960 to 1991. JAMA 1994;272:205-211.
Fegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960-1994. Int J Obes Relat Metab Disord 1998;22:39-47.
Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP. The spread of the obesity epidemic in the United States, 1991-1998. JAMA 1999;282:1519-1522.
Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999-2000. JAMA 2002;288:1723-1727.
Eckel RH, Krauss RM. American Heart Association call to action: ob Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART Study): case-control study. Lancet 2004;364:937-952.
Grundy SM, Cleeman JI, Daniels SR, Donato A, Eckel H, Franklin BA, et al. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-2752.
Berber A, Gómez-Santos R, Fanghänel G, Sánchez-Reyes L. Anthropometric indexes in the prediction of type 2 diabetes mellitus, hypertension and dyslipidaemia in a Mexican population. Int J Obes Relat Metab Disord 2001;25:1794-1799.
Sánchez C, Velázquez MO, Berber A, Lara EA, Tapia CR, James PT. Anthropometric cutoff points for predicting chronic diseases in the Mexican national health survey 2000. Obesity Res 2003;11:442-451.
Saely CH, Koch L, Schmid F, Marte T, Aczel S, Langer P, et al. Adult treatment panel III 2001 but not International Diabetes Federation 2005. Criteria of the metabolic syndrome predict clinical cardiovascular events in subjects who underwent coronary angiography. Diabetes Care 2006;29:901-907.
Lee S, Bacha F, Gungor N, Arslanian SA. Waist circumference is an independent predictor of insulin resistance in black and white youths. J Pediatr 2006;148:188-194.
Palaniappan L, Carnethon M, Wang Y, Hanley A, Fortmann S, Haffner S, et al. Predictors of the Incident Metabolic Syndrome in Adults The Insulin Resistance Atherosclerosis Study. Diabetes Care 2004;27:788-793.
Seidell JC, Bjömtrop P, Sjöstrom L, Sannerstedt R, Krotkiewski M, Kvist H. Regional distribution of muscle and fat mass in men-new insight into the risk of abdominal obesity using computed tomography. Int J Obesity 1989;13:289-303.
Haffner SM, Despres JP, Balkau B, Deanfield JE, Barter P, Bassand JP, et al. Waist circumference and body mass index are both independently associated with cardiovascular disease: The International Day for the Evaluation of Abdominal Obesity (IDEA) survey. J Am Coll Cardiol 2006;47(4 Suppl A):358A. [Abstract 842-846].
Velásquez O, Rosas M, Lara A, Pastelín G, Attié F, Tapia R. Prevalencia e interrelación de enfermedades crónicas no trasmisibles y factores de riesgo cardiovascular en México: ENSA 2000. Arch Cardiol Mex 2003;73:62-77.
Velásquez O, Rosas M, Lara AE, Pastelín G; Grupo ENSA 2000. Hipertensión arterial en México: Resultados de ENSA 2000. Arch Cardiol Mex 2002;72:71-84.
Fanghänel G, Padilla J, Sánchez-Reyes L, Torres E, Cortinas L, Espinosa-Campos J. Prevalence of coronary artery risk factors in workers at the General Hospital General of Mexico of the Ministry of Health. Endocr Practice 1997;3:313-319.
Fanghänel G, Sánchez-Reyes L, Arellano S, Valdez E, Chavira J, Rascón-Pacheco RA. The prevalence of risk factors for coronary disease in workers of the Hospital General de Mexico. Salud Publica Mex 1997;39:427-432.
Fanghänel G, Cortinas L, Sánchez-RL, Berber A. A clinical trial of the use of Sibutramine for the treatment of patients suffering essential obesity. Int J Obes Relat Metab Disord 2000; 24; 144-150.
Fanghänel G, Cortinas L, Sánchez-Reyes L. Berber A. Second phase of a double-blind study clinical trial on Sibutramine for the treatment of patients suffering essential obesity: six months after treatment cross-over. Int J Obes 2001;25:741-747.
Fanghänel G, Sánchez-Reyes L, Berber A. Safety and efficacy of Sibutramine in overweight Hispanic patients with hypertension. Adv Ther 2003;20:101-113.
Sánchez-Reyes L, Fanghänel G, Yamamoto J, Martínez RL, Campos FE, Berber A. Use of sibutramine in overweight and obese Hispanic patients suffering type 2 diabetes mellitus. A 12-month, double blind, randomized, placebo-controlled clinical trial. Clin Ther 2004;26:1427-1435.
Lena VG. Obesity, the metabolic syndrome and cardiovascular disease. Am Heart J 2001;142:1109-1116.
Poinier P, Giles TD, Bray G, Hong Y, Stem J, Pi-Sunyer X, et al. Obesity and cardiovascular disease: pathophysiology, evaluation and effect of weight loss. Circulation 2006;113:898-918.
Dagenais GR, Yi Q, Mann JF, Bosch J, Pogue J, Yusuf S. Prognostic impact of body weight and abdominal obesity in women and men with cardiovascular disease. Am Heart J 2005;149:54-60.