title: Prevalence of metabolically discordant phenotypes in a mediterranean population-The IMAP study.
abstract: OBJECTIVE
  To study the prevalence and correlates of body size phenotypes in an adult Spanish population.
  
  
  METHODS
  We undertook a cross-sectional analysis in a random sample of 2,270 individuals. We defined six body size phenotypes based on body mass index category (normal-weight, 18.5 to 24.9 kg/m2; overweight, 25 to 29.9 kg/m2; obese, ≥30.0 kg/m2) and the presence of ≤1 (metabolically healthy) or ≥2 (metabolically abnormal) cardiometabolic abnormalities: metabolically healthy normal-weight (MHNW), metabolically abnormal normal-weight (MANW), metabolically healthy overweight (MHOW), metabolically abnormal overweight (MAOW), metabolically healthy obese (MHO), and metabolically abnormal obese (MAO). We considered four cardiometabolic abnormalities: systolic and/or diastolic blood pressure ≥130/85 mm Hg, triglycerides ≥150 mg/dL, high-density-lipoprotein cholesterol levels <40/<50 mg/dL in men/women, and elevated glucose (fasting plasma glucose ≥100 mg/dL or previous diabetes).
  
  
  RESULTS
  The prevalence of the MHO, MHOW, and MANW phenotypes was 2.2, 13.9, and 7.9%, respectively. Whereas 9.6% of obese and 32.6% of overweight individuals were metabolically healthy, 21.3% of the normal-weight subjects were metabolically abnormal. A multivariate regression model (adjusted for age, sex, and waist circumference) showed that age >40 years, male sex, and higher waist circumference were independently associated with the metabolically abnormal phenotype MANW, whereas younger age, female sex, and lower waist circumference were independently associated with the metabolically healthy phenotypes.
  
  
  CONCLUSIONS
  The prevalence of MHO in our population is low and is more common in women and younger people. In contrast, a high proportion of normal-weight individuals (mainly over 40 years of age) in our population show cardiometabolic abnormalities.
authors.affiliation: Internal Medicine Department, Carlos Haya Hospital, Malaga, Spain CIBER Fisiopatologia de la Obesidad y la Nutricion (CB06/003), Malaga, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gomez-Huelgas
authors.forename: Dariusz
authors.initials: D
authors.lastname: Narankiewicz
authors.forename: Aurora
authors.initials: A
authors.lastname: Villalobos
authors.forename: Julia
authors.initials: J
authors.lastname: Wärnberg
authors.forename: Jose
authors.initials: J
authors.lastname: Mancera-Romero
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Cuesta
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Tinahones
authors.forename: M Rosa
authors.initials: MR
authors.lastname: Bernal-Lopez
mesh_terms: D000328:Adult; D015992:Body Mass Index; D049628:Body Size / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D015995:Prevalence; D044469:Racial Groups