title: Body size phenotypes and inflammation in the Women's Health Initiative Observational Study.
abstract: Individuals with "metabolically benign" obesity (obesity unaccompanied by hypertension, dyslipidemia, and diabetes) are not at elevated 10-year risk of cardiovascular disease (CVD) compared to normal weight individuals. It remains unclear whether these obese individuals or normal weight individuals with clustering of cardiometabolic factors display heightened immune activity. Therefore, we characterized levels of acute-phase reactants (C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), white blood cell (WBC) count), adhesion molecules (E-selectin, vascular cell adhesion molecule-1), and coagulation products (fibrinogen, plasminogen activator inhibitor-1 (PAI-1)) among four body size phenotypes (normal weight with 0/1 vs. ≥2 metabolic syndrome components/diabetes and overweight/obesity with 0/1 vs. ≥2 metabolic syndrome components/diabetes) in cross-sectional analyses of 1,889 postmenopausal women from the Women's Health Initiative Observational Study (WHI-OS) nested case-control stroke study. Higher levels of all three inflammatory marker categories were found among women with overweight/obesity or ≥2 metabolic syndrome components or diabetes. Compared to normal weight women with 0 or 1 metabolic syndrome components, normal weight women with ≥2 metabolic syndrome components or diabetes were more likely to have ≥3 inflammatory markers in the top quartile (multivariate odds ratio (OR) 2.0, 95% confidence interval (CI): 1.3-3.0), as were overweight/obese women with 0 or 1 metabolic syndrome components (OR 2.3; 95% CI: 1.5-3.5). Overweight/obese women with ≥2 metabolic syndrome components or diabetes had the highest OR (OR 4.2; 95% CI: 2.9-5.9). Despite findings that metabolically benign obese individuals are not at increased 10-year risk of CVD compared to normal weight individuals, the current results suggest that overweight/obese women without clustering of cardiometabolic risk factors still possess abnormal levels of inflammatory markers.
authors.affiliation: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA. rachel.wildman@einstein.yu.edu
authors.forename: Rachel P
authors.initials: RP
authors.lastname: Wildman
authors.forename: Robert
authors.initials: R
authors.lastname: Kaplan
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Rajkovic
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Connelly
authors.forename: Rachel H
authors.initials: RH
authors.lastname: Mackey
authors.forename: Lesley F
authors.initials: LF
authors.lastname: Tinker
authors.forename: J David
authors.initials: JD
authors.lastname: Curb
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
authors.forename: Sylvia
authors.initials: S
authors.lastname: Wassertheil-Smoller
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000097:blood*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D015438:Health Behavior; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000276:immunology*; D050177:Overweight / Q000097:blood / Q000150:complications / Q000276:immunology*; D017698:Postmenopause; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D015815:Cell Adhesion Molecules; D018836:Inflammation Mediators