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Underweight but metabolically abnormal phenotype: Metabolic features and its association with cardiovascular disease

  • Bixia Gao
    Affiliations
    Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China
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  • Luxia Zhang
    Correspondence
    Corresponding author at: Renal Division, Department of Medicine, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing, China, 100034. Tel.: +86 10 83572388; fax: +86 10 66551055.
    Affiliations
    Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China
    Search for articles by this author
  • Minghui Zhao
    Affiliations
    Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China
    Search for articles by this author
  • The China National Survey of Chronic Kidney Disease Working Group Investigator
Published:December 16, 2015DOI:https://doi.org/10.1016/j.ejim.2015.11.020

      Highlights

      • Nearly 20% of underweight people are identified as metabolically abnormal in China.
      • This underweight phenotype has comparable metabolic feature with obese people.
      • This underweight phenotype is associated with presence of cardiovascular disease.

      Abstract

      Background

      Previous studies revealed that among people with normal and high body mass index (BMI), metabolic abnormalities contribute to the increased risk of cardiovascular disease (CVD). However, studies investigating the metabolic features and its association with CVD are limited.

      Methods

      A national representative sample of adult population in China was used. Underweight was defined as BMI <18.5 kg/m2. Participants who had less than 2 criteria of metabolic syndrome were classified as metabolically healthy; those who had 2 or more criteria of metabolic syndrome were classified as metabolically abnormal. Presence of CVD and albuminuria were compared among groups stratified by BMI and metabolic status.

      Results

      Among 46 308 participants, 2267 (4.6%) were classified as underweight; and 372 (16.4%) of them were identified as metabolically abnormal. Metabolic features were comparable between underweight but metabolically abnormal participants and obese participants. Compared with participants with normal weight and normal metabolic features, the underweight but metabolically abnormal participants were more likely to have CVD and albuminuria, with an adjusted odds ratio of 2.33 (95% confidence interval (CI) 1.34–4.05) and 2.56 (95% CI 1.86–3.52), respectively. Among underweight participants, factors associated with metabolic abnormal phenotype included leisure time physical inactivity, mild occupational physical activity, and waist circumference.

      Conclusions

      Metabolically abnormal phenotype is not rare among underweight population in China, and preventive strategy against CVD should also be considered in that population.

      Keywords

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