Gender and age specifics of the association between anthropometric parameters of obesity and lipid metabolism disorders
Authors:   Research Institute of Complex Problems of Cardiovascular Disease Russian Academy of Medical Sciences, Nakhratova O.V. , Tsygankova D.P. ,   Research Institute of Complex Problems of Cardiovascular Disease Russian Academy of Medical Sciences, Gaziev T.F. ,   Research Institute of Complex Problems of Cardiovascular Disease Russian Academy of Medical Sciences, Bazdyrev E.D. ,   Research Institute of Complex Problems of Cardiovascular Disease Russian Academy of Medical Sciences, Indukaeva E.V. ,   Research Institute of Complex Problems of Cardiovascular Disease Russian Academy of Medical Sciences, Artamonova G.V. , Barbarash O.L. ,   Research Institute of Complex Problems of Cardiovascular Disease Russian Academy of Medical Sciences
Published: December 2022

Th e aim of the research. To analyse the relation between gender and age characteristics and various anthropometric parameters of obesity with impaired lipid metabolism among residents of the industrial region of Siberia. Material and methods. A total of 1,600 subjects aged 35-70 were enrolled. Th e mean age was 54.9±9.75 years and 52.6±10.0 years. Th e study was carried out in accordance with Good Clinical Practice and Declaration of Helsinki principles. Prior to inclusion, all respondents signed an informed consent form approved by the institution’s local ethics committee. Th e studied indices of lipid blood spectrum were evaluated using standard tests by Th ermo Fisher Scientifi c, Finland. Th e change in lipid level was assessed according to the “Diagnosis and correction of lipid metabolism disorders for the prevention and treatment of atherosclerosis recommendations, revision 5, 2012. Obesity was assessed based on fi ve anthropometric parameters: body mass index (BMI), waist-to-hip ratio (W/H), waist circumference (WC), skeletal muscle mass-to-visceral fat area ratio (SVR), and visceral adiposity index (VAI). Statistical processing was carried out using Statistica 6.0. Quantitative variables are presented as a median (Me), percentiles (25 %; 75 %) were used as scattering measurements; frequencies (percentages) were used to describe qualitative characteristics. Th eir comparison was carried out using Mann Whitney and Pearson’s Chi-squared test. As an indicator of the contribution of the risk factor (obesity, assessed according to various criteria) to the prevalence of dyslipidemia variants, the values of the predictor signifi cance ranking was used (when using classifi cation trees, discriminant univariate branching was selected and the signifi cance of the predictors was evaluated during the classifi cation process). Results. Hypercholesterolemia was detected in 66.2% of the subjects, hypertriglyceridemia – in 36.3 %. A high level of LDL was found in 75.6 %, and a low level of HDL – in 38.7 % of the respondents. Among men aged 35-49 years, total cholesterol, TG and LDL were higher than in women (p <0.001). At the age of 50-59 years, total cholesterol and LDL cholesterol were higher in women (p <0.001). At the age of 60-70 years, the mean level of total cholesterol and TG was also higher in women than in men (p <0.001). Th e frequency of detection of dyslipidemia, depending on the presence of obesity, diff ered when using all the studied obesity criteria, especially for WC. According to such criteria as BMI, WC, VAI, the prevalence of obesity was higher among women and in men when using the criterion of the area of visceral fat. Th e presence of obesity according to the criteria of WC, W/H and VAI demonstrated the presence of associations with indicators of the entire lipid spectrum. Th e highest values were demonstrated by the presence of obesity according to VAI: it was associated with an increase in TG by 1.23 mmol / l and with a decrease in HDL cholesterol by 0.49 mmol / l (p <0.001). At a younger age, indicators characterising a poorer lipid profi le (high values of TC and LDL, low HDL) were found in males, while with increasing age, these changes in lipid metabolism were observed in the female patients. When performing linear regression analysis, the greatest infl uence was demonstrated by age (rank 100 for hypercholesterolemia and high LDL cholesterol) and VAI (rank 100 for hypertriglyceridemia and low HDL). Th e rest of the studied obesity criteria demonstrated approximately the same value of the ranks for all studied parameters characterising lipid metabolism. It should be noted that the sex showed the lowest values for all the studied parameters of the lipid spectrum. Conclusion. When analysing the relationship between gender and age characteristics and various anthropometric parameters of obesity with impaired lipid metabolism, the following patterns were revealed among the inhabitants of a large industrial region of Siberia, according to the data of this epidemiological study. Th us, such parameters as VAI, WC, W/H, which characterise obesity, are more reliable while assessing the risk associations for development of dyslipidaemia, in contrast to the classical assessment of obesity by BMI. It should be noted that VAI was a more signifi cant criterion in assessing the risk of hypertriglyceridemia and low HDL levels. Considering the gender and age of the surveyed respondents, the following diff erences were revealed. Male subjects of younger age were characterised by higher results of LDL, total cholesterol and HDL. With increasing age, this trend changed and a more unfavourable course of dyslipidaemia was observed in females. Th is study proves the need to take into account the extended parameters of obesity when assessing dyslipidaemia. Th e use of extended criteria for assessing obesity will provide additional information in the management of patients with dyslipidaemia. However, further research is needed to fi nd out whether the identifi ed patterns are regional features or may be projected on all residents of our state.