Exploring New Tools for Risk Classification among Adults with Several Degrees of Obesity

Abstract

The epidemic of obesity worldwide has been recognized as a very important challenge. Within its complexity, the identification of higher-risk patients is essential, as it is unsustainable to offer access to treatment to all people with obesity. Several new approaches have recently been presented as important tools for risk stratification. In this research, we applied several of these tools in a cross-sectional study involving adults with obesity classes I, II, III, and super-obesity. The participants had their cardiometabolic risk profiles assessed. The study included adults with obesity aged 18 to 50 years (n = 404), who were evaluated using anthropometric, body composition, hemodynamic, physical fitness, and biochemical assessments. These variables were used to identify the prevalence of risk factors for cardiometabolic diseases according to the classes of obesity by gender and age group. The results showed high prevalence of risk factors, especially among the upper classes of obesity (BMI > 35 kg/m²) using single parameters as the waist circumference, with almost 90% above the cut-off point. For smaller numbers such as Glycated Hemoglobin, however, the prevalence was around 30%. Indexes such as the atherogenic index of plasma (AIP) had the highest prevalence, with 100% of the male participants identified as being at increased risk for cardiovascular disease.

Keywords: AIP; HOMA-IR; metabolic syndrome; obesity; risk assessment; risk stratification.

Figure 1

Prevalence of alterations in single parameters used in the diagnosis of metabolic risk.

Figure 2

Prevalence of alterations in ratios or indexes based on the combination of single parameters used in the diagnosis of metabolic risk.

Figure 3

Relationship between two indexes of metabolic risk, the Atherogenic Index of Plasma (AIP) and the Metabolic Syndrome Severity Score (MetSs).