Comorbidity results of an obesity center

Year 2025, Volume: 11 Issue: 2, 378 - 386

Müjgan Tuna , Şenay Kırlak , Seydahmet Akın , Özlem Çakır Madenci

https://doi.org/10.18621/eurj.1602748

Abstract

Objectives: Obesity is linked to numerous severe health conditions, including type 2 diabetes mellitus, heart disease, hypertension, and stroke. This study aimed to compare metabolic parameters and anthropometric measurements between male and female patients with obesity to identify gender-based differences in obesity-related health markers.

Methods: This prospective study enrolled 393 obese patients (52 male, 341 female) from an outpatient clinic. After an overnight fast (8-10 hours), blood samples were collected to assess a range of parameters: complete blood count, fasting blood glucose, insulin, Hemoglobin A1c (HbA1c), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Thyroid-stimulating hormone (TSH), total cholesterol, triglycerides, Low-density lipoprotein (LDL), High-density lipoprotein (HDL), 25-hydroxy vitamin D3 (25OHD3), ferritin, iron, and vitamin B12. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and Body Mass Index (BMI) were calculated, while soft lean mass (SLM) and percent body fat (PBF) were also analyzed.

Results: Males with obesity had significantly higher levels of insulin, HOMA-IR, 25OHD3, ferritin, iron, hemoglobin, hematocrit, urea, and ALT compared to females (P<0.05 for all). Conversely, males had lower HDL and platelet levels (P<0.05). The prevalence of thyroid disease was significantly higher in females (P=0.027).

Conclusions: Thyroid disease prevalence was significantly higher in females compared to males. Additionally, metabolic parameters such as insulin, HOMA-IR, and urea were elevated in females, while HDL and platelet levels were lower in males.

Keywords

Obesity, insulin resistance, metabolic parameters, diabetes mellitus, body mass index

Ethical Statement

This study was approved by the Kartal Dr. Lütfi Kırdar City Hospital Clinical Research Ethics Committee (Decision no: 2021/514/208/11 and date: 25.08.2021). All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Informed consent was obtained from all participants.

References

• 1. Zhang X, Ha S, Lau HC, Yu J. Excess body weight: Novel insights into its roles in obesity comorbidities. Semin Cancer Biol. 2023;92:16-27. doi:10.1016/j.semcancer.2023.03.008.
• 2. World Health Organisation. WHO European Regional Obesity Report 2022. 2022 [cited 2022 Nov 8]; Available from: https://apps.who.int/iris/handle/10665/353747.
• 3. Nutter S, Eggerichs LA, Nagpal TS, et al. Changing the global obesity narrative to recognize and reduce weight stigma: A position statement from the World Obesity Federation. Obes Rev. 2024;25(1):e13642. doi:10.1111/obr.13642.
• 4. Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev. 2024;20(1):2-26. doi:10.2174/1573396318666220801093225.
• 5. TÜİK. Türkiye Sağlık Araştırması, 2019. https://data.tuik.gov.tr/Bulten/Index?p=Turkey-Health-Survey-2019-3366. Erişim tarihi 25 Ağustos, 2023.
• 6. Engin A. Adiponectin Resistance in Obesity: Adiponectin Leptin/Insulin Interaction. Adv Exp Med Biol. 2024;1460:431-462. doi:10.1007/978-3-031-63657-8_15.
• 7. Yazıcı D, Demir SÇ, Sezer H. Insulin Resistance, Obesity, and Lipotoxicity. Adv Exp Med Biol. 2024;1460:391-430. doi:10.1007/978-3-031-63657-8_14.
• 8. Adeva-Andany MM, Domínguez-Montero A, Adeva-Contreras L, Fernández-Fernández C, Carneiro-Freire N, González-Lucán M. Body Fat Distribution Contributes to Defining the Relationship between Insulin Resistance and Obesity in Human Diseases. Curr Diabetes Rev. 2024;20(5):e160823219824. doi:10.2174/1573399820666230816111624.
• 9. Kloock S, Ziegler CG, Dischinger U. Obesity and its comorbidities, current treatment options and future perspectives: Challenging bariatric surgery? Pharmacol Ther. 2023;251:108549. doi:10.1016/j.pharmthera.2023.108549.
• 10. Arner P, Viguerie N, Massier L, et al. Sex differences in adipose insulin resistance are linked to obesity, lipolysis and insulin receptor substrate 1. Int J Obes (Lond). 2024;48(7):934-940. doi:10.1038/s41366-024-01501-x.
• 11. Gado M, Tsaousidou E, Bornstein SR, Perakakis N. Sex-based differences in insulin resistance. J Endocrinol. 2024;261(1):e230245. doi:10.1530/JOE-23-0245.
• 12. Shantaram D, Hoyd R, Blaszczak AM, et al. Obesity-associated microbiomes instigate visceral adipose tissue inflammation by recruitment of distinct neutrophils. Nat Commun. 2024;15(1):5434. doi:10.1038/s41467-024-48935-5.
• 13. Shaikh SR, Beck MA, Alwarawrah Y, MacIver NJ. Emerging mechanisms of obesity-associated immune dysfunction. Nat Rev Endocrinol. 2024;20(3):136-148. doi:10.1038/s41574-023-00932-2.
• 14. Aguirre-García MM, Amedei A, Hernández-Ruiz P, et al. Cytokine and microbiota profiles in obesity-related hypertension patients. Front Cell Infect Microbiol. 2024;13:1325261. doi:10.3389/fcimb.2023.1325261.
• 15. Pena-Leon V, Perez-Lois R, Villalon M, et al. Novel mechanisms involved in leptin sensitization in obesity. Biochem Pharmacol. 2024;223:116129. doi:10.1016/j.bcp.2024.116129.
• 16. Chandrasekaran P, Weiskirchen R. The Role of Obesity in Type 2 Diabetes Mellitus-An Overview. Int J Mol Sci. 2024;25(3):1882. doi:10.3390/ijms25031882.
• 17. Verde L, Di Lorenzo T, Savastano S, Colao A, Barrea L, Muscogiuri G. Chrononutrition in type 2 diabetes mellitus and obesity: A narrative review. Diabetes Metab Res Rev. 2024;40(2):e3778. doi:10.1002/dmrr.3778.
• 18. Ragab AAY, Doyle MF, Chen J, Fang Y, Lunetta KL, Murabito JM. Immune cell phenotypes and mortality in the Framingham Heart Study. Immun Ageing. 2024;21(1):37. doi: 10.1186/s12979-024-00431-6.
• 19. Dang K, Wang X, Hu J, et al. The association between triglyceride-glucose index and its combination with obesity indicators and cardiovascular disease: NHANES 2003-2018. Cardiovasc Diabetol. 2024;23(1):8. doi:10.1186/s12933-023-02115-9.
• 20. Rempakos A, Prescott B, Mitchell GF, Vasan RS, Xanthakis V. Association of Life's Essential 8 With Cardiovascular Disease and Mortality: The Framingham Heart Study. J Am Heart Assoc. 2023;12(23):e030764. doi:10.1161/JAHA.123.030764.
• 21. Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88. doi: 10.1186/1471-2458-9-88.
• 22. Nguyen NT, Magno CP, Lane KT, Hinojosa MW, Lane JS. Association of hypertension, diabetes, dyslipidemia, and metabolic syndrome with obesity: findings from the National Health and Nutrition Examination Survey, 1999 to 2004. J Am Coll Surg 2008;207(6):928-934.
• 23. Faeh D, Braun J, Tarnutzer S, Bopp M. Obesity but not overweight is associated with increased mortality risk. Eur J Epidemiol. 2011;26(8):647-655. doi: 10.1007/s10654-011-9593-2.
• 24. Chu FL, Hsu CH, Jeng C. Lowered cutoff points of obesity indicators are better predictors of hypertension and diabetes mellitus in premenopausal Taiwanese women. Obes Res Clin Pract. 2015;9(4):328-335. doi: 10.1016/j.orcp.2014.08.001.
• 25. Fujita M, Hata A. Sex and age differences in the effect of obesity on incidence of hypertension in the Japanese population: A large historical cohort study. J Am Soc Hypertens. 2014;8(1):64-70. doi: 10.1016/j.jash.2013.08.001.
• 26. Aoyama T, Li D, Bay JL. Weight Gain and Nutrition during Pregnancy: An Analysis of Clinical Practice Guidelines in the Asia-Pacific Region. Nutrients. 2022;14(6):1288. doi:10.3390/nu14061288.
• 27. Sandalcı U, Tuncer G. [An Evaluation of Direct and Indirect Costs of Obesity]. Aksaray Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi. 2020;12(2):29-44. [Article in Turkish]