title: Differentiation of obese patients at moderate or higher Findrisc score based on their atherogenic index.
abstract: OBJECTIVE
  The purpose of this study was to reveal different subgroups of patients with at least moderate risk of developing diabetes in the next 10 years, based on clustering of cardiovascular risk factors.
  
  
  METHODS
  We performed a one-center cross-sectional study of adult patients (n = 109, median age 45 years) with Findrisc score of above 11 out of 26 maximum. We included in the cluster analysis anthropometrics, lipid and carbohydrate parameters obtained in oral glucose tolerance test (OGTT), insulin, C-peptide, creatinine, C-reactive protein, liver enzymes, beta-cell function, insulin sensitivity and insulin resistance (HOMA calculations). We also evaluated the atherogenic index of plasma (AIP).
  
  
  RESULTS
  We identified three metabolic phenotypes of patients with at least moderate Findrisc score-one 'male' (cluster AM, n = 24), and two 'female' phenotypes (cluster AW, n = 9 and cluster BW, n = 76). Men were almost homogenous for their metabolic phenotype, with lower fat percentage than women (p < .05). Most of the women (cluster BW, n = 76) presented with better metabolic pattern i.e. lower insulin resistance, lower C-reactive protein, lower degree of obesity and visceral fat rating (p < .05), despite the higher fat percentage (p < .05). Some of the women, however, (cluster AW, n = 9) presented with parameters very similar to that of men (cluster AM) and significantly higher than in cluster BW. Despite the lack of significant differences in lipid parameters among clusters, AIP was significantly lower in cluster BW (p < .05).
  
  
  CONCLUSIONS
  Most of the women presented with clearly less unfavorable atherogenic risk than men. Two different phenotypes of obese women with at least moderate Findrisc score were revealed, and the level of inflammation seems to be the main discriminant factor. Larger prospective studies are required to elucidate whether those are really two different pathogenically phenotypes or if they belong to the same phenotype's continuum.
authors.affiliation: a Department of Pharmacology and Toxicology, Medical Faculty , Medical University of Sofia , Sofia , Bulgaria.|b Department of Internal Medicine, Pharmacology and Clinical Pharmacology, Pediatrics, Epidemiology, Infectious Diseases and Dermatology, Medical Faculty , University of Sofia 'St Kliment Ohridski,' , Sofia , Bulgaria.
authors.forename: Pavlina A
authors.initials: PA
authors.lastname: Andreeva-Gateva
authors.affiliation: c Department of Endocrinology, Medical Faculty , Medical University of Plovdiv , Plovdiv , Bulgaria.
authors.forename: Petya
authors.initials: P
authors.lastname: Konsulova
authors.affiliation: c Department of Endocrinology, Medical Faculty , Medical University of Plovdiv , Plovdiv , Bulgaria.
authors.forename: Maria
authors.initials: M
authors.lastname: Orbetzova
authors.affiliation: d Department of Medical Chemistry and Biochemistry, Medical Faculty , Medical University of Sofia , Sofia , Bulgaria.
authors.forename: Radka
authors.initials: R
authors.lastname: Georgieva-Nikolova
authors.affiliation: e Department of Pathophysiology, Medical Faculty , Medical University of Sofia , Sofia , Bulgaria.
authors.forename: Radka
authors.initials: R
authors.lastname: Tafradjiiska-Hadjiolova
authors.affiliation: f Department of Chemistry, Faculty of Pharmacy , Medical University of Sofia , Sofia , Bulgaria.
authors.forename: Violina
authors.initials: V
authors.lastname: Angelova
authors.affiliation: f Department of Chemistry, Faculty of Pharmacy , Medical University of Sofia , Sofia , Bulgaria.
authors.forename: Yulian
authors.initials: Y
authors.lastname: Voynikov
authors.affiliation: g Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy , Medical University of Sofia , Sofia , Bulgaria.
authors.forename: Irina
authors.initials: I
authors.lastname: Nikolova
authors.affiliation: h Pre-admission Ward , Specialized Hospital of Infections and Parasitic Diseases 'Prof. Ivan Kirov ,' Sofia , Bulgaria.
authors.forename: Iscra
authors.initials: I
authors.lastname: Simova
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000453:epidemiology; D001786:Blood Glucose; D001837:Body Weights and Measures; D002097:C-Reactive Protein; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D004032:Diet; D015444:Exercise; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D008055:Lipids; D002097:C-Reactive Protein
keywords: Obesity; atherogenic index of plasma; diabetes type 2 risk; inflammation; prediabetes