LINK TO RESEARCH
Juan P González-Rivas,
W Timothy Garvey,
Jeffrey I Mechanick
Objective: To determine the prevalence of obesity according to the American
Association of Clinical Endocrinologists/American College of Endocrinology
(AACE/ACE) framework based on a complications-centric model with further
application of the Cardiometabolic Disease Staging (CMDS) system in a
Methods: A total of 1,320 adults were randomly selected from 3 regions. The
AACE/ACE framework definitions were as follows: overweight, body mass index
(BMI) 25 to 29.9 kg/m2 and no obesity-related complications (ORC); obesity stage 0, BMI ≥30 and
no ORC; stage 1, BMI ≥25 and 1 or more mild-to-moderate ORC; and stage 2,
BMI ≥25 and 1 or more severe ORC. CMDS definitions were as follows: stage
0, no metabolic syndrome (MS) components; stage 1, 1 to 2 MS components
without impaired fasting glucose (IFG); stage 2, IFG or ≥3 MS components
but without IFG; stage 3, IFG and MS; and stage 4, type 2 diabetes (T2D) or
Results: The mean age was 44.8 ± 0.4 years, and 68.5% were female. The prevalence
of obesity according to the AACE/ACE framework was 63.1%: overweight 3.0%
(95% confidence interval [CI]: 2.1-3.9); obesity stage 0: 0.1% (0.07-0.27);
obesity stage 1: 26.6% (24.2-29.0); and obesity stage 2: 36.4% (33.8-39.0).
Most subjects with a BMI <25 were CMDS 0 or 1. In those with BMI ≥ 25, only 4.6% were CMDS 0. The prevalence of obesity according to the World Health Organization (WHO, BMI ≥30) was 29.3% (24.7-33.7). Conclusion: In a general population study, applying the AACE/ACE framework for obesity and CMDS increased the detection of ORC and therefore higher risk subjects compared to classic anthropometric measurements. Abbreviations: AACE = American Association of Clinical Endocrinologists; ACE = American College of Endocrinology; BMI = body mass index; CMDS = Cardiometabolic Disease Staging; DALY = disability-adjusted life years; LA = Latin America; MS = metabolic syndrome; ORC = obesity-related complications; WC = waist circumference; WHO = World Health Organization.
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