Association between Cardio-Metabolic and Hepatic Indices and, Dietary Intake between Metabolically Obesity Groups: A Cross-Sectional Study of the Hoveyzeh Cohort

Document Type : Original Article(s)

Authors

1 Associate Professor, Department of Internal Medicine, Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Subspecialty Resident of Endocrinology & Metabolism, Department of Internal Medicine, Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

3 Assistant Professor, Department of Nutrition, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran

4 Assistant Professor, Department of Internal Medicine, Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Abstract

Background: The role of metabolic status on cardiovascular disease, hepatic steatosis and, nutrition between metabolically obesity groups is unclear. This study aimed to compare the cardio-metabolic and hepatic indices and, among dietary intake among metabolically obesity groups.
Methods: In this cross-sectional study, 7464 participants in the city of Hoveyzeh classified into four groups: MHNW: Metabolically Healthy Normal Weight, MUNW: Metabolically Unhealthy Normal Weight, MHOO: Metabolically Healthy Overweight/obese, MUOO: Metabolically Unhealthy Overweight/obese. Cardio-metabolic and hepatic indices and, dietary intake were compared among groups.
Findings: The MUOO high risk group had the highest frequency (57.36%) among the metabolic obesity groups. The values of Waist to Hip Ratio (WHR), Visceral Adiposity Index (VAI) and Weight-Adjusted Waist Index (WWI) and, most of the cardio-metabolic indices in metabolically unhealthy groups were significantly higher but, hepatic indices in overweight-obese groups were significantly greater. The MUNW and MUOO groups had the most positive relation with Lipoprotein Combine Index (LCI) and Hepatic Steatosis Index (HSI), respectively. The highest intake of total fat and mono-unsaturated fatty acid was in the MHNW and MHOO groups, and the highest intake of saturated fat was in MHNW group.
Conclusion: MUNW group had a higher risk for cardiovascular diseases than MHOO group. The association between metabolic health and cardiovascular diseases is more important than obesity with that. Hepatic steatosis and non-alcoholic fatty liver risk were higher in the individuals with abnormal weights.

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Main Subjects

References

  1. Trayhurn P, Wood IS. Adipokines: inflammation and the pleiotropic role of white adipose tissue. Br J Nutr 2004; 92(3): 347-55.
  2. Mirmiran P, Moslehi N, Hosseinpanah F, Sarbazi N, Azizi F. Dietry determinants of unhealthy metabolic phenotype in normal weight and overweight / obese adults: results of prospective study. Int J Food Sci Nutr 2020; 71(7): 891-901.
  3. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third report of the national cholesterol education program (NCEP) export panel on detection, evaluation and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation 2002; 106(25): 3143-421.
  4. Lejawa M, Osadnik K, Czuba Z, Osadnik T, Pawlas N. Association of metabollicaly healthy and unhealthy obesity phenotype with markers related to obesity, diabetes among young, healthy adult men. Analysis of MAGNETIC study. Life (Basel) 2021; 11(12): 1350.
  5. Blüher M. The distinction of metabolically healthy from
    unhealthy obese individuals. Curr Opin Lipidol 2010; 21(1): 38-43.
  6. Pluta W, Dudzińska W, Lubkowska A. Metabolic Obesity in people with Normal Body Weight (MONW) - Review of Diagnostic Criteria. Int J Environ Res Public Health 2022; 19(2): 624.
  7. Stępień M, Stępień A, Wlazeł RN, Paradowski M, Rizzo M, Banach M, et al. Predictors of insulin resistance in patients with obesity a pilot study. Angiology 2014; 65(1): 22-30.
  8. Abolnezhadian F, Hosseini SA, Alipour M, Zakerkish M, Cheraghian B, Ghandil P, et al. Association metabolic obesity phenotypes with cardio-metabolic index, atherogenic index of plasma and novel anthropometric indices: A ;ink of FTO-rs9939609 polymorphism. Vasc Health Risk Manag 2020; 16: 249-56.
  9. Masaad AA, Yusuf AM, Shakir AZ, Khan MS, Khaleel S, Cheikh Ismail L, et al. Sleep quality and dietary inflammatory index among university students: A cross-sectional study. Sleep Breath 2020; 25(4): 2221-9.
  10. Wirth MD, Hébert JR, Shivappa N, Hand GA, Hurley
    TG, Drenowatz C, et al. Anti-inflammatory Dietary Inflammatory Index scores are associated with healthier scores on other dietary indices. Nutr Res 2016; 36(3): 214-9.
  11. Fowler ME, Akinyemiju TF. Meta-analysis of the association between dietary inflammatory index (DII) and cancer outcomes. Int J Cancer 2017; 141(11): 2215-27.
  12. Hankinson AL, Daviglus ML, Van Horn L, Chan Q, Brown I, Holmes E, et al. Diet composition and activity level of at risk and metabolically healthy obese American adults. Obesity (Silver Spring) 2013; 21(3): 637-43.
  13. Al-Khalidi B, Kimball SM, Kuk JL, Ardern CI. Metabolically healthy obesity, vitamin D and all Cause and cardio-metabolic mortality risk in NHANES III. Clin Nutr 2018; 38(2): 820-8.
  14. Cheraghian B, Hashemi SJ, Hosseini SA, Poustchi H, Rahimi Z, Sarvandian S, et al. Cohort profile: The Hoveyzeh Cohort Study (HCS): A prospective population-based study on non-communicable diseases in an Arab community of Southwest Iran. Med J Islam Repub Iran 2020; 34(1): 974-81.
  15. Esmaillzadeh A, Azadbakht L. Major dietary patterns in relation to general obesity and central adiposity among Iranian women. J Nutr 2008; 138(2): 358-63.
  16. Craig C, Marshall A, Sjostrom M, Bauman A, Lee P, Macfarlane D, et al. International physical activity questionnaire-short form. J Am Coll Health 2017; 65: 492-501.
  17. Nusrianto R, Ayundini G, Kristanti M, Astrella C, Amalina N, Muhadi, et al. Visceral adiposity index and lipid accumulation product as a predictor of type 2 diabetes mellitus: the Bogor cohort study of non-communicable diseases risk factors. Diabetes Res Clin Pract 2019; 155: 107798.
  18. Mirmiran P, Hosseini Esfahani FH, Mehrabi Y, Hedayati M, Azizi F. Reliability and relative validity of an FFQ for nutrients in the Tehran Lipid and Glucose Study. Public Health Nutr 2010; 13(5): 654-62.
  19. Saghafi-Asl M, Mimajidi S, Asghary Jafarabadi M, Vahid F, Shivappa N, Hebert JR, et al. The association of dietary patterns with dietary inflammatory index, systemic inflammation and insulin resistance in apparently healthy individuals with obesity. Sci Rep 2015; 11(1): 7515.
  20. Shadnoush M, Rajabian Tabesh M, Asadzadeh-Aghdaei H, Hafizi N, Alipour M, Zahedi H, et al. Effect of bariatric surgery on atherogenicity and insulin resistance in patients with obesity class II: a prospective study. BMJ Open 2023; 13: e072418.
  21. Wang J, Li P, Jiang Z, Yang Q, Mi Y, Liu Y, et al. Diagnostic value of alcoholic liver disease (ALD)/nonalcoholic fatty liver disease (NAFLD) index combined with γ-glutamyl transferase in differentiating ALD and NAFLD. Korean J Intern Med 2016; 31(3): 479-87.
  22. Xintian C, Junli H, Wen W, Wang J, Wang M, Liu S,
    et al. Association of the cardio-metabolic index with the risk of cardiovascular disease in patients with hypertension and obstructive sleep apnea: Results of a longitudinal cohort study. Oxid Med Cell Longev 2022; 2022: 4914791.
  23. Buscemi S, Chiarello P, Buscemi C, Corleo D, Massenti MF, Barile AM, et al. Characterization of metabolically healthy obese people and metabolically unhealthy normal-weight people in a general population cohort of the ABCD study. J Diabetes Res 2017; 2017: 9294038.
  24. Liao C, Gao W, Cao W, Lv J, Yu C, Wang S, et al. Association of metabolic/obesity phenotypes with insulin resistance and C-Reactive Protein: Results from the CNTR study. Diabetes Metab Syndr Obes 2021; 14: 1141-51.
  25. Yoo HK, Choi EY, Park EW, Cheong YS, Bae RA. Comparison of metabolic characteristics of metabolically healthy but obese (MHO) middle-aged men according to different criteria. Korean J FAM Med 2013; 34(1): 19-26.
  26. Kimokoti RW, Judd SE, Shikany JM, Newby PK. Metabolically healthy obesity is not associated with food intake in white or black men. J Nutr 2015; 145(11): 2551-61.
  27. Messier V, Karelis AD, Robillard ME, Bellefeuille P, Brochu M, Lavoie JM, et al. Metabolically healthy but obese individuals: Relationship with hepatic enzymes. Metabolism 2010; 59(1): 20-4.
  28. Baveicy K, Mostafaei S, Darbandi M, Hamzeh B, Najafi F, Pasdar Y. Predicting metabolic syndrome by Visceral Adiposity Index, Body Roundness Index and a Body Shape Index in adults: A cross sectional study from the Iranian RanNCD Cohort Data. Diabetes Metab Syndr Obes 2020; 13: 879-87.
  29. Dunn W, Angulo P, Sanderson S, Jamil LH, Stadheim L, Rosen C, et al. Utility of a new model to diagnose an alcohol basis for steato-hepatitis. Gastroenterology 2006; 131(4): 1057-63.
  30. Messier V, Karelis AD, Robillard ME, Bellefeuille P, Brochu M, Lavoie JM, et al. Metabolically healthy but obese individuals : relationship with hepatic enzymes. Metabolism 2010; 59(1): 20-4.
  31. Stefan N, Kantartzis K, Haring HU. Causes and metabolic consequences of fatty liver. Endocr Rev 2008; 29(7): 939-60.
  32. Vusirikala A, Thomas T, Bhala N, Tahrani AA, Thomas GN, Nirantharakumar K. Impact of obesity and metabolic health status in the development of non-alcoholic fatty liver disease (NAFLD): A United Kingdom population-based cohort study using the health improvement network (THIN). BMC Endocr Disord 2020; 20(1): 96.
  33. Ellulu MS, Patimah I, Khaza’ai H, Rahmat A, Abed Y. Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci 2017; 13(4): 851-63.
  34. Jin YJ, Kim KM, Hwang S, Lee SG, Ha TY, Song GW, et al. Exercise and diet modification in non obese non-alcoholic fatty liver disease: Analysis of biopsies of living liver donors. J Gastroenterol Hepatol 2012; 27(8): 1341-7.
  35. Li YW, Kao TW, Chang PK, Chen WL, Wu LW. Atherogenic index of plasma as predictors for metabolic syndrome, hypertension and diabetes mellitus in Taiwan citizens: a 9-year longitudinal study. Sci Rep 2020; 11(1): 9900.
  36. Morales-Gurrola G, Simental-Mendía LE, Castellanos-Juárez FX, Salas-Pacheco JM, Guerrero-Romero F. The triglycerides and glucose index is associated with cardiovascular risk factors in metabolically obese normal-weight subjects. J Endocrinol Invest 2020; 43(7): 995-1000.
  37. Gao M, Lv J, Yu C, Guo Y, Bian Z, Yang R, et al. Metabolically healthy obesity, transition to unhealthy metabolic status, and vascular disease in Chinese adults: A cohort study. PLoS Med 2020; 17(10): e1003351.
  38. Eckel N, Meidtner K, Kalle-Uhlmann T, Stefan N, Schulze MB. Metabolically healthy obesity and cardiovascular events: a systematic review and meta-analysis. Eur J Prev Cardiol 2016; 23(9): 956-66.
  39. Li L, Chen K, Wang AP, Gao JQ, Zhao K, Wang HB, et al. Cardiovascular disease outcomes in metabolically healthy obesity in communities of Beijing cohort study. Int J Clin Pract 2018; e13279.
  40. Stefan N, Kantartzis K, Machann J, Schick F, Thamer C, Rittig K, et al. Identification and characterization of metabolically benign obesity in humans. Arch Intern Med 2008; 168(15): 1609-16.
  41. Appel LJ, Sacks FM, Carey VJ, Obarzanek E, Swain JF, Miller 3rd ER, et al. Effects of protein, monounsaturated fat and carbohydrate intake on blood pressure and serum lipids. JAMA 2005; 294(19): 2455-64.
  42. Phillips CM, Dillon C, Harrington JM, McCarthy VJ, Kearney PM, Fitzgerald AP, et al. Defining metabolically healthy obesity: role of dietary and lifestyle factors. PLoS One 2013; 8(10): e76188.
  43. Conus F, Allison DB, Rabasa-Lhoret R, St-Onge M, St-Pierre DH, Tremblay-Lebeau A, et al. Metabolic and behavioral characteristics of metabolically obese but normal-weight women. J Clin Endocrinol Metab 2004; 89(10): 5013-20.
  44. Choi J, Se-Young O, Lee D, Tak S, Hong M, Park SM, et al. Characteristics of diet patterns in metabolically obese, normal weight adults (Korean National Health and Nutrition Examination Survey III, 2005). Nutr Metab Cardiovasc Dis 2012; 22(7): 567-74.
  45. Dibaba DT, Xun P, Fly AD, Yokota K, He K. Dietary magnesium intake and risk of metabolic syndrome: a meta-analysis. Diabet Med 2014; 31(11): 1301-9.
  46. Qorbani M, Movasaghi N, Mohammadian Khonsari N, Daneshzad E, Shafiee G, Ashraf H, et al. Association of zinc serum level with metabolic syndrome in Iranian children and adolescents: The CASPIAN-V study. Front Nutr 2022; 9: 932746.
  47. Bibiloni MDM, Bouzas C, Abbate M, Martínez-González MA, Corella D, Salas-Salvadó J, et al. Nutrient adequacy and diet quality in a Mediterranean population with metabolic syndrome: A cross-sectional study. Clin Nutr 2003; 39(3): 853-61.
  48. Köse S, Sözlü S, Bölükbaşi H, Ünsal N, Gezmen-Karadağ M. Obesity is accociated with folat metabolism. Int J Vitam Nutr Res 2019; 90(3-4): 200-4.
  49. Al-Khalidi B, Kimball SM, Kuk JL, Ardern CI. Metabolically healthy obesity, vitamin D and all Cause and cardio-metabolic mortality risk in NHANES III. Clin Nutr 2018; 38(2): 820-8.
  50. Esteghamati A, Aryan Z, Esteghamati A, Nakhjavani M. Differences in vitamin D concentration between metabolically healthy and unhealthy obese adults: Associations with inflammatory and cardio-metabolic markers in 4391 subjects. Diabetes Metab 2014; 40(5): 347-55.
  51. Arsic A, Takic M, Kojadinovic M, Petrovic S, Paunovic M, Vucic V, et al. Metabilically healthy obesity: is there a link with polyunsaturated fatty acid intake and status. Can J Physiol Pharmacol 2021; 99(1): 64-71.
  52. Yu S, Xie Q, Tan W, Hu M, Xu G, Zhang X, et al. Different ratios of DHA/EPA reverses insulin resistance by improving adiposyte dysfunction and lipid disorders in HFD-induced IR mice. Food Funct 2023; 14(2): 1179-97.
  53. Sohrab G, Ebrahimof S, Hosseinpour-Niazi S, Yuzbashian E, Mirmiran P, Azizi F. Association of dietary intakes of total polyphenol and its subclasses with the risk of metabolic syndrome: Tehran Lipid and Glucose Study. Metab Syndr Relat Disord 2018; 16(6): 274-81.
  54. Labunskyy VM, Lee BC, Handy DE, Loscalzo J, Hatfield DL, Gladyshev VN. Both maximal expression of selenoproteins and selenoprotein deficiency can promote development of type 2 diabetes-like phenotype in mice. Antioxid Redox Signal 2011; 14(12): 2327-36.
Journal of Isfahan Medical School
Volume 41, Issue 723
3rd Week, August
July and August 2023
Pages 464-478

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History

  • Receive Date: 12 March 2023
  • Accept Date: 09 August 2023

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