AUTHOR=Davids Saarah Fatoma , Matsha Tandi Edith , Peer Nasheeta , Erasmus Rajiv Timothy , Kengne Andre Pascal 

TITLE=Changes in Obesity Phenotype Distribution in Mixed-ancestry South Africans in Cape Town Between 2008/09 and 2014/16

JOURNAL=Frontiers in Endocrinology

VOLUME=10

YEAR=2019

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2019.00753

DOI=10.3389/fendo.2019.00753

ISSN=1664-2392

ABSTRACT=<p><bold>Background:</bold> The concept of obesity phenotypes encompasses a different approach to evaluating the relationship between obesity and cardiometabolic diseases. Considering the minimal research on obesity phenotypes in Africa, we investigated these changes from 2008/09 to 2014/16 in the mixed ancestry population in Cape Town, South Africa.</p><p><bold>Methods:</bold> In all, 928 (2008/09) and 1969 (2014/16) ≥20 year old participants were included in two community-based cross-sectional studies. For obesity phenotype classification, a combination of body mass index (BMI) categories and prevalent cardiometabolic disease risk factors were used, with the presence of ≥2 cardiometabolic abnormalities defining abnormal metabolic status. Interaction tests were used to investigate changes in their distribution across the years of study.</p><p><bold>Results:</bold> Distribution of BMI categories differed significantly between the 2 years; normal weight, overweight and obese: 27.4, 27.4, and 45.3% in 2008/09 vs. 34.2, 23.6, and 42.2% in 2014/16 (<italic>p</italic> = 0.001). There was no differential effect in the distribution of obesity phenotypes pattern across the two time-points (interaction <italic>p</italic> = 0.126). Across BMI categories, levels of cardiometabolic risk factors linearly deteriorated in both metabolically healthy and abnormal participants (all <italic>p</italic> ≤ 0.018 for linear trends). Findings were not sensitive to the number of metabolic abnormalities included in the definition of obesity phenotypes.</p><p><bold>Conclusions:</bold> Our study showed negligible differences in obesity phenotypes over time, but a high burden of metabolic abnormalities among normal weight participants, and a significant proportion of metabolically health obese individuals. Further investigation is needed to improve risk stratification and cost-effective identification of individuals at high risk for cardiometabolic diseases.</p>