title: Association of body mass index with cardiovascular disease biomarkers.
abstract: BACKGROUND
  Few studies have examined the underweight-morbidity relationship, and those that have were conducted in non-U.S. populations and limited in their evaluation of cardiovascular disease (CVD) risk factors.
  
  
  OBJECTIVE
  To examine the associations among underweight (along with overweight and obese) and various CVD risk factors in a national sample of U.S. adults (aged ≥20 years).
  
  
  METHODS
  Ten years of data (1999-2010) from the National Health and Nutrition Examination Survey were used (analyzed in 2014). Underweight (tertiles); overweight (25-29.9); and obesity (three classes: 30-34.9, 35-39.9, and ≥40) were assessed from measured BMI. The evaluated biological and anthropometric markers included waist circumference; mean arterial pressure; C-reactive protein (CRP); fasting low-density lipoprotein (LDL) cholesterol; total cholesterol; fasting triglycerides; and fasting glucose.
  
  
  RESULTS
  After adjustments, underweight adults had significantly (p<0.005) lower levels of CRP (β=-0.12, Tertile 2); total cholesterol (β=-17.7 and -12.2, Tertiles 1 and 3); total cholesterol to high-density lipoprotein cholesterol ratio (β=-0.39 and -0.46, Tertiles 2 and 3); LDL cholesterol (β=-20.7, Tertile 1); and triglycerides (β=-37.1 and -18.0, Tertiles 1 and 3) compared to normal-weight individuals. The severely underweight and obese were less likely to be physically active than normal-weight adults (p<0.001). Adults in each of the overweight and obese groups had higher levels for each biomarker compared to normal-weight individuals.
  
  
  CONCLUSIONS
  Underweight adults have lower (i.e., more favorable) levels of various CVD biomarkers.
authors.affiliation: Department of Health, Exercise Science, and Recreation Management, School of Applied Sciences, The University of Mississippi, University, Mississippi. Electronic address: pdloprin@olemiss.edu.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Loprinzi
authors.affiliation: School of Community Health, Portland State University, Portland.
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Crespo
authors.affiliation: Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.
authors.forename: Ross E
authors.initials: RE
authors.lastname: Andersen
authors.affiliation: Program in Epidemiology, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon.
authors.forename: Ellen
authors.initials: E
authors.lastname: Smit
mesh_terms: D000328:Adult; D015415:Biomarkers; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D001837:Body Weights and Measures; D002097:C-Reactive Protein; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids; D002097:C-Reactive Protein