The relation of rapid changes in obesity measures to lipid profile - insights from a nationwide metabolic health survey in 444 Polish cities.
OBJECTIVE
The impact of fast changes in obesity indices on other measures of metabolic health is poorly defined in the general population. Using the Polish accession to the European Union as a model of political and social transformation we examined how an expected rapid increase in body mass index (BMI) and waist circumference relates to changes in lipid profile, both at the population and personal level.


METHODS
Through primary care centres in 444 Polish cities, two cross-sectional nationwide population-based surveys (LIPIDOGRAM 2004 and LIPIDOGRAM 2006) examined 15,404 and 15,453 adult individuals in 2004 and 2006, respectively. A separate prospective sample of 1,840 individuals recruited in 2004 had a follow-up in 2006 (LIPIDOGRAM PLUS).


RESULTS
Two years after Polish accession to European Union, mean population BMI and waist circumference increased by 0.6% and 0.9%, respectively. This tracked with a 7.6% drop in HDL-cholesterol and a 2.1% increase in triglycerides (all p<0.001) nationwide. The direction and magnitude of the population changes were replicated at the personal level in LIPIDOGRAM PLUS (0.7%, 0.3%, 8.6% and 1.8%, respectively). However, increases in BMI and waist circumference were both only weakly associated with HDL-cholesterol and triglycerides changes prospectively. The relation of BMI to the magnitude of change in both lipid fractions was comparable to that of waist circumference.


CONCLUSIONS
Moderate changes in obesity measures tracked with a significant deterioration in measures of pro-atherogenic dyslipidaemia at both personal and population level. These associations were predominantly driven by factors not measureable directly through either BMI or waist circumference.
Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom ; Deutsches Herzzentrum, Technische Universität, Munich, Germany ; Department for Internal Medicine II, University Hospital Regensburg, Regensburg, Germany.
Bernhard M
BM
Kaess
Department of Public Health, Częstochowa University of Technology, Częstochowa, Poland ; Silesian Analytical Laboratories, Katowice, Poland.
Jacek
J
Jóźwiak
Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom ; The NIHR Leicester Biomedical Research Unit in Cardiovascular Disease, Leicester, United Kingdom.
Christopher P
CP
Nelson
Department of Family Medicine, Medical University of Silesia, Zabrze, Poland.
Witold
W
Lukas
Silesian Analytical Laboratories, Katowice, Poland.
Mirosław
M
Mastej
Department of Family Medicine, Jagiellonian University Medical College, Kraków, Poland.
Adam
A
Windak
Department of Family Medicine, Jagiellonian University Medical College, Kraków, Poland.
Tomasz
T
Tomasik
Department of Internal Diseases, Diabetology and Nephrology, Medical University of Silesia, Zabrze, Poland.
Władysław
W
Grzeszczak
Department of Hypertension, Vascular Diseases, and Internal Diseases, University of Medical Sciences, Poznań, Poland.
Andrzej
A
Tykarski
Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland.
Jerzy
J
Gąsowski
Department of Public Health, Częstochowa University of Technology, Częstochowa, Poland.
Izabella
I
Ślęzak-Prochazka
Department of Public Health, Częstochowa University of Technology, Częstochowa, Poland.
Andrzej
A
Ślęzak
Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom ; School of Health Sciences, University of Ballarat, Ballarat, Australia.
Fadi J
FJ
Charchar
Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom.
Naveed
N
Sattar
The NIHR Leicester Biomedical Research Unit in Cardiovascular Disease, Leicester, United Kingdom ; Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
John R
JR
Thompson
Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom ; The NIHR Leicester Biomedical Research Unit in Cardiovascular Disease, Leicester, United Kingdom.
Nilesh J
NJ
Samani
Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom ; The NIHR Leicester Biomedical Research Unit in Cardiovascular Disease, Leicester, United Kingdom.
Maciej
M
Tomaszewski
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D002947:Cities; D003430:Cross-Sectional Studies; D005062:European Union; D005215:Fasting / Q000097:blood; D005260:Female; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D050356:Lipid Metabolism; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000503:physiopathology; D011044:Poland; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
D008076:Cholesterol, HDL; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol