Impact of the new EASO obesity definition on the detection of atheromatosis in subjects with low-to-moderate cardiovascular risk
Por:
León-Mengíbar, J, Bermúdez-López, M, Valdivielso, JM, Pamplona, R, Torres, G, Mauricio, D, Castro-Boqué, E, Fernández, E, Caixàs, A, Bueno, M, Ciudin, A, Hernández, M, Simó, R, Hernández, C, Lecube, A
Publicada:
10 oct 2025
Resumen:
Background: Traditional body mass index (BMI) does not adequately reflect adipose tissue distribution and associated cardiovascular (CV) risk. To improve risk stratification, the European Association for the Study of Obesity (EASO) proposes to extend the diagnosis of obesity to include individuals with a BMI of 25-30 kg/m(2), a waist-to-height ratio (WtHR) >= 0.5, and any obesity-related complication. Objective: To examine whether this new definition of obesity can better identify the presence of subclinical atheromatosis disease (SAD) in terms of arterial plaque burden compared to the classical BMI-based definition. Methods: A cross-sectional including 8,330 participants from the ILERVAS project (ClinicalTrials.gov Identifier: NCT03228459), aged 45-70 years with low-to-moderate CV risk and no previous CV disease, was included. Obesity was classified using traditional (BMI >= 30 kg/m(2)) and new definitions. Atherosclerosis was assessed through Doppler ultrasound of carotid and femoral arteries. Logistic regression models adjusted for cardiovascular risk factors were used to evaluate associations between obesity definitions and SAD. Results: The new definition increased obesity prevalence from 37.2% to 71.7%. It also revealed higher detection of atheromatous plaques (72.9% vs. 68.6%, p < 0.001) and affected more vascular territories. Multivariable analysis showed the new definition independently predicted overall plaque presence (OR 1.54, 95% CI 1.22-1.94, p < 0.001) and femoral atherosclerosis (OR 1.36, 95% CI 1.10-1.68, p = 0.004). Similar results were obtained when only WtHR was considered, excluding obesity-related complications. Conclusion: The new obesity definition identifies more efficiently individuals at risk for atherosclerosis, especially in the femoral region, compared to the classic BMI definition. Further studies to assess the cost-effectiveness of this approach seem warranted.
Filiaciones:
León-Mengíbar, J:
Univ Lleida, Univ Hosp Arnau de Vilanova Lleida, Inst Recerca Biomed Lleida IRBLleida, Obes Diabet & Metab ODIM Res Grp,Dept Endocrinol &, Lleida, Spain
Bermúdez-López, M:
ISCIII, Renal Res Network RICORS2040, Inst Recerca Biomed Lleida RBLleida, Vasc & Renal Translat Res Grp, Lleida, Spain
Univ Lleida, Dept Expt Med, Lleida, Spain
Valdivielso, JM:
ISCIII, Renal Res Network RICORS2040, Inst Recerca Biomed Lleida RBLleida, Vasc & Renal Translat Res Grp, Lleida, Spain
Pamplona, R:
Univ Lleida, Dept Expt Med, Inst Recerca Biomed Lleida IRBLleida, Lleida, Spain
Torres, G:
Inst Hlth Carlos III, Univ Hosp Arnau de Vilanova & Santa Maria, Inst Recerca Biomed Lleida IRBLleida, CIBER Resp Dis CIBERES,Translat Res Resp Med, Lleida, Spain
Mauricio, D:
Autonomous Univ Barcelona, Hosp Santa Creu & St Pau, CIBERDEM Inst Hlth Carlos III, Dept Endocrinol & Nutr, Barcelona, Spain
Castro-Boqué, E:
ISCIII, Renal Res Network RICORS2040, Inst Recerca Biomed Lleida RBLleida, Vasc & Renal Translat Res Grp, Lleida, Spain
Fernández, E:
ISCIII, Renal Res Network RICORS2040, Inst Recerca Biomed Lleida RBLleida, Vasc & Renal Translat Res Grp, Lleida, Spain
Caixàs, A:
Univ Autonoma Barcelona, Parc Tauli Hosp Univ, Inst Invest & Innovacio Parc Tauli IPT CERCA, Med Dept, Sabadell, Spain
Bueno, M:
Univ Lleida, Univ Hosp Arnau de Vilanova Lleida, Inst Recerca Biomed Lleida IRBLleida, Obes Diabet & Metab ODIM Res Grp,Dept Endocrinol &, Lleida, Spain
Ciudin, A:
Inst Hlth Carlos III, Univ Hosp Vall dHebron, Inst Recerca Vall dHebron VHIR, Diabet & Metab Res Grp,Dept Endocrinol & Nutr, Barcelona, Spain
Hernández, M:
Univ Lleida, Univ Hosp Arnau de Vilanova Lleida, Inst Recerca Biomed Lleida IRBLleida, Obes Diabet & Metab ODIM Res Grp,Dept Endocrinol &, Lleida, Spain
Simó, R:
Inst Hlth Carlos III, Univ Hosp Vall dHebron, Inst Recerca Vall dHebron VHIR, Diabet & Metab Res Grp,Dept Endocrinol & Nutr, Barcelona, Spain
Hernández, C:
Inst Hlth Carlos III, Univ Hosp Vall dHebron, Inst Recerca Vall dHebron VHIR, Diabet & Metab Res Grp,Dept Endocrinol & Nutr, Barcelona, Spain
Lecube, A:
Inst Hlth Carlos III, Univ Hosp Vall dHebron, Inst Recerca Vall dHebron VHIR, Diabet & Metab Res Grp,Dept Endocrinol & Nutr, Barcelona, Spain
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