Visceral obesity augments prescription use: An analysis of the cross-sectional study of NHANES 2011-2018

Abstract

Background: Visceral obesity (VATob) increases the risk for many diseases. Central obesity has been associated with an augmented prescription use; however, there is a paucity of research focused on VATob. Here, the aim was to evaluate the association between VATob and prescription use.

Methods: Data was collected from the NHANES dataset (2011-2018). Visceral adipose tissue was measured using dual x-ray absorptiometry, and VATob was defined as ≥100 cm2. Prescription use was collected from the RXQ_RX files and classified according to Vademecum. Association between VATob and prescription use was determined with logistic regression and reported as odds ratios (ORs) with 95% confidence intervals (95%CIs).

Results: 10,952 participants (weighted: 121,090,702) were included, in which 41.8% were VATob and 52.0% of them had ≥1 prescription. Overall, VATob demonstrated an augmented rate of prescription use when compared to non-VATob (52.0% versus 36.7%, p<0.001), specifically with metabolic (4.5-fold increase), cardiovascular (3.9-fold increase), gastrointestinal (2.5-fold increase), and hematopoietic agents (2.3-fold increase). This was associated with increased the risk for overall prescription use (ORoverall = 1.9, 95%CI: 1.7-2.1, p<0.001). Similar results were observed with metabolic and cardiovascular agents. However, when stratified by BMI, normal weight participants (ORmetabolic = 10.4; 95%CI: 6.5-16.6 & ORcardiovascular = 7.0; 95%CI: 4.4-11.1, p<0.001) had a greater risk than the overweight (ORmetabolic = 4.1; 95%CI: 3.0-5.6 & ORcardiovascular = 3.4; 95%CI: 2.5-4.7, p<0.001) or obese participants (ORmetabolic = 3.5; 95%CI: 2.3-5.3 & ORcardiovascular = 3.5; 95%CI: 2.5-4.9, p<0.001).

Conclusion: VATob is associated with augmented prescription use, particularly with cardiovascular and metabolic agents. This association was higher for normal weight participants.

Fig 1. Flow chart of the screening process for selecting eligible participants to assess the effect visceral obesity has on prescription use.

Fig 2. Visceral adipose tissue (VAT) affects prescription use.

Means (dot) and standard error (bars) plots were constructed the determine the relationship between VAT and number of prescriptions (A) and the number of medication classes (B).

Fig 3. The effect of visceral obesity (VATob) has on prescription use.

Bar charts were constructed for the percentage who were taking 0 (A), 1 (B), 2 (C), 3 (D), 4 (E), or ≥5 (F) prescriptions. For each panel, the rate of use for the complete cohort (Total, white bar) or when stratified into non-VATob (checkered bar) or VATob (black bar) was determined for the total cohort (Total) or when stratified by BMI class: normal weight (NW), overweight (OW), obese class 1 (OB1), and obese class 2 (OB2). * Indicates a significant difference (p<0.05) between non-VATob and VATob group.

Fig 4. The effect of visceral obesity (VATob) has on the number of medication classes taken.

Bar charts were constructed for the percentage who were taking 0 (A), 1 (B), 2 (C), 3 (D), 4 (E), or ≥5 (F) different medication classes. For each panel, the rate of use for the complete cohort (Total, white bar) or when stratified into non-VATob (checkered bar) or VATob (black bar) was determined for the total cohort (Total) or when stratified by BMI class: normal weight (NW), overweight (OW), obese class 1 (OB1), and obese class 2 (OB2). * Indicates a significant difference (p<0.05) between non-VATob and VATob group.