Poster Topical Area: Obesity
Location: Hall D
Poster Board Number: 736
Objectives: The aim of this study was to select risk factors of development of obesity-associated complications, such as diabetes and cardiovascular diseases (myocardial infarction, stroke, death), occurred over a period of 3 years in an overweight or obese adult population that had been evaluated by metabolic and nutritional biochemical markers.
Methods: In the framework of a research project on the relationship between nutritional deficiencies and obesity, 175 both genders overweight or obese adults (52.3±13.8 Y) were studied. We evaluated, among a wide set of variables, parameters of metabolic syndrome (MS) defined by ATP III and IDF, HbA1c, and high sensitive C-reactive protein (hs-CRP). These patients then entered a weight loss program characterized by healthy eating and exercise guidelines for 6 months. After 3 years, 109 of the patients were contacted again by telephone and major events they suffered during that period were recorded.
Results: Major events were recorded in 13 patients: 9 developed diabetes and 4 cardiovascular events, of which 2 died. Profile of patients who suffered events was compared with those who did not. Of all parameters performed -shown or not-, the one that best discriminated between the two groups was hs-CRP. The MS did not predict the risk (46% vs 44% according to ATP III and 46% vs 42% according to IDF). The groups presented significant differences in fasting glucose (103.8±13.2 vs 97.0±11.1; P=0.0476, t test) and HbA1c (5.68±0.47 vs 5.36±0.47; P=0.0279, t test), but not as much as in CRP (9.29±10.64 vs 4.38±4.24; P= 0.0064, Mann Whitney test). The area under the ROC curve of CRP was 0.734. Analyzing the cut-off points, it was found that a CRP ≥5 mg/L significantly predicted the appearance of events (P = 0.0095, RR: 4.378, Fisher's exact test), with a sensitivity of 69.2% and a specificity of 70.8%. Events developed in 24.3% of those with CRP ≥5 mg/L and only 5.5% of CRP <5 mg/L.
Conclusions: In this study, hs-CRP, a marker of inflammation, was the one most associated with the development of cardiometabolic events, such as diabetes and cardiovascular events, so its inclusion as a prognostic marker is recommended. Values ≥5 mg/L are those that presented the best relationship between sensitivity and specificity.
Supported by University of Buenos Aires UBACyT 20720130100006BA.
Universidad de Buenos Aires - Facultad de Farmacia y Bioquímica
Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina