Traditional and novel cardiometabolic risk markers across strata of body mass index in young adults

Mia Klinkvort Kempel; Trine Nøhr Winding; Vibeke Lynggaard; Steven Brantlov; Johan Hviid Andersen; Morten Böttcher

doi:10.1002/osp4.528

Traditional and novel cardiometabolic risk markers across strata of body mass index in young adults

Obes Sci Pract. 2021 Jun 1;7(6):727-737. doi: 10.1002/osp4.528. eCollection 2021 Dec.

Authors

Mia Klinkvort Kempel¹, Trine Nøhr Winding¹, Vibeke Lynggaard², Steven Brantlov³, Johan Hviid Andersen¹, Morten Böttcher²

Affiliations

¹ Department of Occupational Medicine - University Research Clinic Danish Ramazzini Centre Regional Hospital West Jutland Herning Denmark.
² Cardiovascular Research Unit Department of Cardiology Gødstrup Hospital Herning Denmark.
³ Department of Procurement and Clinical Engineering Central Denmark Region Aarhus Denmark.

Abstract

Background: Cardiometabolic risk increases with increasing body mass index (BMI). The exact mechanism is poorly understood, and traditional risk assessment of young adults with obesity has shown to be ineffective. Greater knowledge about potential new effective biomarkers and the use of advanced cardiac imaging for risk assessment in young adults is, therefore, necessary.

Objective: This study aims to explore traditional and novel cardiometabolic risk markers across strata of BMI in young adults.

Methods: Participants (N = 264, 50% women, age 28-30 years) were invited from an ongoing cohort study, based on BMI and sex. BMI-strata were: BMI <25, 25-30, >30 kg/m², representing normal weight (NW), overweight (OW), and obesity (OB). Participants underwent cardiac computed tomography to detect coronary artery calcification, measures of body composition, blood pressure measurements, and a comprehensive panel of circulating cardiometabolic risk markers.

Results: No significant coronary artery calcifications were detected in this study. Minor differences in median levels of traditional risk markers were detected across BMI-strata, for example, total cholesterol (men- NW: 4.7 (4.3-5.1) and OB: 4.8 (4.2-5.6) mmol/L, p = 0.58; women- NW: 4.3 (3.9-4.8) and OB: 4.7 (4.2-5.3) mmol/L, p = 0.016), whereas substantial differences were seen in markers of inflammation and glucose metabolism, for example, high sensitive CRP (men- NW: 0.6 (0.3-1.1) and OB: 2.8 (1.5-4.0) mg/L, p < 0.001; women- NW: 0.7 (0.3-1.7) and OB: 4.0 (2.2-7.8) mg/L, p < 0.001) and insulin (men- NW: 47.0 (35.0-59.0) and OB: 113.5 (72.0-151.0) pmol/L, p < 0.001; women- NW: 44.0 (35.0-60.0) and OB: 84.5 (60.0-126.0) pmol/L, p < 0.001).

Conclusion: In young adults, obesity is associated with an early onset insulin resistance and inflammatory response prior to development of coronary artery calcification and deterioration of lipid profiles.

Keywords: body mass index; cardiovascular risk; inflammation; obesity; risk management.