Prevalence of normal weight obesity and its associated cardio-metabolic risk factors – Results from the baseline data of the Kerala Diabetes Prevention Program (KDPP)

Kapoor, Nitin; Lotfaliany, Mojtaba; Sathish, Thirunavukkarasu; Thankappan, Kavumpurathu Raman; Nicolaï, Thomas; Furler, John; Oldenburg, Brian; Tapp, Robyn J.

doi:10.1371/journal.pone.0237974

Cited by 64 publications

(71 citation statements)

References 41 publications

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“…The prevalence of pre-HT/HT in lean adolescents (27.4%) further emphasises that O/O plays a decisive, though not an exclusive role in the development of hypertension. 40–42 …”

Section: Discussionmentioning

confidence: 99%

Cardiometabolic risk factors and early indicators of vascular dysfunction: a cross-sectional cohort study in South African adolescents

et al. 2021

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ObjectivesPrevalence of child and adolescents’ overweight and obesity in low- and middle-income countries has increased dramatically. Simultaneously, the incidence of pre-hypertension/hypertension is also increasing in children, which, in turn, predisposes these children to the risk of cardiovascular disease (CVD) in later life. The present study assessed cardiometabolic risk factors and early indicators of vascular dysfunction in adolescents from a low socio-economic rural area in South Africa.DesignCross-sectional cohort study.SettingThe study was conducted in public schools in Mthatha, OR Tambo district municipality, Eastern Cape Province, South Africa.ParticipantsA total of 244 adolescents (188 females) of African ancestry aged 13–16 years were enrolled.Primary and secondary outcome measuresAnthropometric and haemodynamic measures and pulse wave velocity (PWV) were related to overweight/obesity and hypertension. Blood markers of cardiometabolic syndrome were assessed as well as vascular function (via PWV).ResultsOne-third (33.0%) of the adolescents exceeded the age and sex-specific body mass index percentiles for overweight (≥85th) or obesity (>95th) with a prevalence of 61.1% pre-hypertensives in this group. Overweight/obesity and hypertension were associated with higher triglycerides (lean:overweight: 0.79<1.01 mmol/L; normotensive:hypertensive: 0.82<0.89 mmol/L). Fasting glucose was higher in hypertensive as compared to normotensive adolescents (4.85>4.69 mmol/L, p<0.05). PWV was elevated in 25.9% of the children and significantly correlated with asymmetric dimethylarginine and systolic blood pressure (p<0.001).ConclusionOverweight/obesity and hypertension show a high prevalence in rural South African youth. Almost half of the studied adolescents are at risk for developing CVD. The high association between cardiometabolic risk factors and PWV further suggests that hypertension in adolescents may promote the progression of CVD in adulthood. Early detection of those at risk and the implementation of preventive strategies in underprivileged young people is urgently needed to stop the progression of vascular damage and manifestation of CVD in rural African children.

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“…The prevalence of pre-HT/HT in lean adolescents (27.4%) further emphasises that O/O plays a decisive, though not an exclusive role in the development of hypertension. 40–42 …”

Section: Discussionmentioning

confidence: 99%

Cardiometabolic risk factors and early indicators of vascular dysfunction: a cross-sectional cohort study in South African adolescents

et al. 2021

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“…Obesity is conventionally defined as BMI ≥ 30 kg/m 2 , while BMI between 25.0 and 29.9 kg/m 2 is defined as overweight[ 7 ]. Asians have higher body fat percentage at lower values of BMI[ 16 , 17 ]; thus, more stringent criteria have been used to define obesity in the Asian population[ 18 , 19 ]. Table 2 depicts the classification system used to define obesity internationally and for Asia.…”

Section: Classification Of Obesity and Diabetesmentioning

confidence: 99%

Expert opinion on the preoperative medical optimization of adults with diabetes undergoing metabolic surgery

Bhattacharya¹,

Kalra²,

Kapoor³

et al. 2021

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Diabetes mellitus (DM) and obesity are interrelated in a complex manner, and their coexistence predisposes patients to a plethora of medical problems. Metabolic surgery has evolved as a promising therapeutic option for both conditions. It is recommended that patients, particularly those of Asian origin, maintain a lower body mass index threshold in the presence of uncontrolled DM. However, several comorbidities often accompany these chronic diseases and need to be addressed for successful surgical outcome. Laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) are the most commonly used bariatric procedures worldwide. The bariatric benefits of RYGB and LSG are similar, but emerging evidence indicates that RYGB is more effective than LSG in improving glycemic control and induces higher rates of long-term DM remission. Several scoring systems have been formulated that are utilized to predict the chances of remission. A glycemic target of glycated hemoglobin < 7% is a reasonable goal before surgery. Cardiovascular, pulmonary, gastrointestinal, hepatic, renal, endocrine, nutritional, and psychological optimization of surgical candidates improves perioperative and long-term outcomes. Various guidelines for preoperative care of individuals with obesity have been formulated, but very few specifically focus on the concerns arising from the presence of concomitant DM. It is hoped that this statement will lead to the standardization of presurgical management of individuals with DM undergoing metabolic surgery.

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“…BMI does not distinguish between lean mass and fat mass, nor throws light on fat distribution. The literature shows that body fat distribution and not excess weight is associated with many obesity-related risk factors [ 21 , 22 , 23 , 24 ]. Accurate body fat estimation techniques like computed tomography or magnetic resonance imaging are very costly and require sophisticated equipment [ 25 ].…”

Section: Endocrine Evaluation Of Obesitymentioning

confidence: 99%

Barocrinology: The Endocrinology of Obesity from Bench to Bedside

et al. 2020

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Obesity has reached pandemic proportions. Hormonal and metabolic imbalances are the key factors that lead to obesity. South Asian populations have a unique phenotype, peculiar dietary practices, and a high prevalence of consanguinity. Moreover, many lower middle-income countries lack appropriate resources, super-specialists, and affordability to manage this complex disorder. Of late, there has been a substantial increase in both obesity and diabesity in India. Thus, many more patients are being managed by different types of bariatric procedures today than ever before. These patients have many types of endocrine and metabolic disturbances before and after bariatric surgery. Therefore, these patients should be managed by experts who have knowledge of both bariatric surgery and endocrinology. The authors propose “Barocrinology”, a novel terminology in medical literature, to comprehensively describe the field of obesity medicine highlighting the role of knowing endocrine physiology for understating its evolution, insights into its complications and appreciating the changes in the hormonal milieu following weight loss therapies including bariatric surgery. Barocrinology, coined as a portmanteau of “baro” (weight) and endocrinology, focuses upon the endocrine and metabolic domains of weight physiology and pathology. This review summarizes the key pointers of bariatric management from an endocrine perspective.

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Prevalence of normal weight obesity and its associated cardio-metabolic risk factors – Results from the baseline data of the Kerala Diabetes Prevention Program (KDPP)

Cited by 64 publications

References 41 publications

Cardiometabolic risk factors and early indicators of vascular dysfunction: a cross-sectional cohort study in South African adolescents

Cardiometabolic risk factors and early indicators of vascular dysfunction: a cross-sectional cohort study in South African adolescents

Expert opinion on the preoperative medical optimization of adults with diabetes undergoing metabolic surgery

Barocrinology: The Endocrinology of Obesity from Bench to Bedside

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