TRANSITION FROM METABOLICALLY HEALTHY OBESITY TO UNHEALTHY OBESITY IN ADULTS FROM ELSA BRAZIL: A LONGITUDINAL ANALYSIS
Name: FERNANDA DUARTE MENDES
Publication date: 23/07/2024
Examining board:
Name |
Role |
|---|---|
| CARLA ROMAGNOLLI QUINTINO | Examinador Externo |
| CAROLINA PERIM DE FARIA | Presidente |
| VALDETE REGINA GUANDALINI | Examinador Interno |
Summary: This is a longitudinal study with baseline data (2008/10) and wave 3 (2017/19) from
the Longitudinal Study of Adult Health (ELSA-Brasil). The objective is to describe the
trajectory of metabolic status in individuals with obesity and the factors associated
with the transition to an unhealthy status. Metabolic status was determined using
blood pressure, fasting glucose and/or hemoglobin A1c, triglycerides, and HDL
cholesterol. Individuals should not have a prior diagnosis of any alterations in these
parameters or be taking medication to control them. If any parameter is altered, it is
considered metabolically unhealthy obesity (ObMNS); otherwise, it is classified as
metabolically healthy obesity (ObMS). Dietary intake was classified according to the
degree of food processing, based on the NOVA classification. Physical activity was
measured using the International Physical Activity Questionnaire (IPAQ).
Sociodemographic variables were collected through a standardized questionnaire,
with interviews conducted at each ELSA-Brasil center. For statistical analyses, the
Student's t-test and/or Mann-Whitney test were used for continuous variables, and
the chi-square or Fisher's exact test for categorical variables. SPSS software version
21.0 was used, with a significance level of 5%. Among the 190 ObMS participants
included at baseline, 75.8% transitioned to ObMNS status after an average follow-up
of 7.7 years. Alcohol use was considered a risk factor for the transition of metabolic
status [RR: 1.359 (95% CI: 1.005 - 1.838)]. Additionally, each 1 cm increase in waist
circumference (WC) contributed to a 1% increase in the risk of transitioning from
healthy to unhealthy metabolic status [RR: 1.011 (95% CI: 1.004 - 1.018)]. It can be
concluded that metabolic health is transient, as most participants transitioned from
ObMS to ObMNS. Alcohol consumption was associated with a higher risk of
metabolic status deterioration. Furthermore, the accumulation of visceral fat appears
to influence the risk of changes in metabolic status. Therefore, it is emphasized that
classifying individuals with obesity is important to identify metabolic status and the
presence of risk factors for losing a healthy status.
