| Peer-Reviewed

Metabolic Disorders and Metabolically Obese Normal-Weight in Burkinabe Adults: Increasing Prevalences Across Normal BMI Quartiles, Using the 2013 STEPS Database

Received: 18 January 2023    Accepted: 16 March 2023    Published: 24 March 2023
Views:       Downloads:
Abstract

Background: Majority of Burkinabè adults were normal-weight by body mass index (BMI). This study explored by gender, the metabolic abnormalities and “metabolic obesity with body weight” (MONW) throughout the normal BMI quartiles (Q) of Burkinabè adults. Methods: We performed a secondary-analysis of data from the first WHO Stepwise approach to surveillance survey conducted in 2013 in Burkina Faso, and only adults with BMI between 18.5 – 24.9 kg/m² were included. Metabolic disorders (individual abnormal metabolic syndrome component, having at least two abnormalities and MONW) were described in BMI’ quartiles, for each gender, and the risk of occurrence of having at least two abnormalities or MONW was analysed using quartiles as dependent variables, after adjustment on sociodemographic and lifestyle factors. Results: In the 3112 adults with normal BMI and despite their gender, low high-density lipoprotein cholesterol was widespread (>75%) and its distribution did not differ across quartiles, as for raised fasting blood glucose (its prevalence was low ≈ 8%). Elevated blood pressure was the predominant abnormality in overall men (35.3%) with a significant increment starting at Q3 and reached 42.8% in Q4, while abdominal obesity was predominant in overall women (27.2%) with a significant increase starting at Q2, and reached 53.8% in Q4. In men, MONW was low (2.3%), while 30.6% had at least two abnormalities with an increasing pick starting at Q3, and prevalence was 38.0% in Q4. In women, the prevalence of MONW and those with at least two abnormalities was 8% and 39% respectively, with a common significant elevation beginning at Q3 and respectively reached 16% and 56% in Q4. Independently of sociodemographic and lifestyle factors, the number of metabolic abnormalities started to increase at Q3 in both sexes. Conclusion: Prevalence of adults with at least two metabolic abnormalities was considerable, and the number of abnormalities increased with normal BMI, and more severely in female gender in whom the prevalence of MONW was alarming. Abnormalities should also be early screened in normal-weight Burkinabè adults, more especially when their BMI reaches the Q3 cut-offs, i.e., 21.5 and 21.1 kg/m² respectively for men and women.

Published in Central African Journal of Public Health (Volume 9, Issue 2)
DOI 10.11648/j.cajph.20230902.12
Page(s) 49-56
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Normal-Weight, BMI, Metabolic Disorders, Metabolically Obese Normal-Weight, 2013 Burkina Faso STEPS

References
[1] Abrahams Z, McHiza Z, Steyn NP. Diet and mortality rates in Sub-Saharan Africa: stages in the nutrition transition. BMC Public Health. 2011; 11: 801.
[2] Bosu WK. An overview of the nutrition transition in West Africa: implications for non-communicable diseases. Proc Nutr Soc. 2015; 74: 466–77.
[3] Macia E, Cohen E, Boetsch G, Boetsch L, Cohen E, Duboz P. Prevalence of obesity and body size perceptions in urban and rural Senegal: new insight on the epidemiological transition in West Africa. Cardiovasc J Afr. 2017; 28: 324–30.
[4] Haider MR, Das Gupta R. Inequalities in undiagnosed hypertension among adult Nepalese population: Evidence from a nationally representative survey. Int J Cardiol Hypertens. 2020; 5: 100026.
[5] Bjerggaard M, Philipsen A, Jørgensen ME, Charles M, Witte DR, Sandbæk A, et al. Association of self-perceived body image with body mass index and type 2 diabetes—The ADDITION-PRO study. Prev Med. 2015; 75: 64–9.
[6] Oliveros E, Somers VK, Sochor O, Goel K, Lopez-Jimenez F. The concept of normal weight obesity. Prog Cardiovasc Dis. 2014; 56: 426–33.
[7] Ruderman N, Chisholm D, Pi-Sunyer X, Schneider S. The metabolically obese, normal-weight individual revisited. Diabetes. 1998; 47: 699–713.
[8] Pluta W, Dudzińska W, Lubkowska A. Metabolic Obesity in People with Normal Body Weight (MONW)-Review of Diagnostic Criteria. Int J Environ Res Public Health. 2022; 19: 624.
[9] Meigs JB, Wilson PWF, Fox CS, Vasan RS, Nathan DM, Sullivan LM, et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab. 2006; 91: 2906–12.
[10] Hyun YJ, Koh SJ, Chae JS, Kim JY, Kim OY, Lim HH, et al. Atherogenecity of LDL and unfavorable adipokine profile in metabolically obese, normal-weight woman. Obes Silver Spring Md. 2008; 16: 784–9.
[11] Chooi YC, Ding C, Chan Z, Choo J, Sadananthan SA, Michael N, et al. Moderate Weight Loss Improves Body Composition and Metabolic Function in Metabolically Unhealthy Lean Subjects. Obes Silver Spring Md. 2018; 26: 1000–7.
[12] Yaya S, Ekholuenetale M, Bishwajit G. Differentials in prevalence and correlates of metabolic risk factors of non-communicable diseases among women in sub-Saharan Africa: evidence from 33 countries. BMC Public Health. 2018; 18: 1168.
[13] Diendéré J, Millogo A, Philippe F, Kaboré J, Napon C, Dabilgou A, et al. Post-stroke Complications and Mortality in Burkinabè Hospitals: Relationships with Deglutition Disorders and Nutritional Status. Dysphagia. 2020; 36: 85–95.
[14] Diendéré J, Kaboré J, Somé JW, Tougri G, Zeba AN, Tinto H. Prevalence and factors associated with overweight and obesity among rural and urban women in Burkina Faso. Pan Afr Med J. 2019; 34.
[15] World Health Organization. WHO steps surveillance manual: the WHO stepwise approach to chronic disease risk factor surveillance. Geneva: World Health Organization; 2005.
[16] Claydon NC. Current concepts in toothbrushing and interdental cleaning. Periodontol 2000. 2008; 48: 10–22.
[17] Bull FC, Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009; 6: 790–804.
[18] World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Technical Report 894. Geneva: World Health Organization; 2000.
[19] Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med J Br Diabet Assoc. 2006; 23: 469–80.
[20] Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007; 49: 403–14.
[21] Després JP, Lemieux I, Prud’homme D. Treatment of obesity: need to focus on high risk abdominally obese patients. BMJ. 2001; 322: 716–20.
[22] Romero-Corral A, Somers VK, Sierra-Johnson J, Korenfeld Y, Boarin S, Korinek J, et al. Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality. Eur Heart J. 2010; 31: 737–46.
[23] Frongillo EA, Nanama S. Development and validation of an experience-based measure of household food insecurity within and across seasons in northern Burkina Faso. J Nutr. 2006; 136: 1409S-1419S.
[24] Delisle H, Ntandou G, Sodjinou R, Couillard C, Després J-P. At-risk serum cholesterol profile at both ends of the nutrition spectrum in West African adults? The Benin study. Nutrients. 2013; 5: 1366–83.
[25] Ruiz-Ramie JJ, Barber JL, Sarzynski MA. Effects of exercise on HDL functionality. Curr Opin Lipidol. 2019; 30: 16–23.
[26] Sang H, Yao S, Zhang L, Li X, Yang N, Zhao J, et al. Walk-run training improves the anti-inflammation properties of high-density lipoprotein in patients with metabolic syndrome. J Clin Endocrinol Metab. 2015; 100: 870–9.
[27] Diendéré J, Bosu WK, Ouédraogo W-LR, Ouattara S, Konsem T, Zeba AN, et al. How alcohol and/or tobacco use and raised glycemia are associated with oral hygiene practices among Burkinabè adults: Evidence from the first national non-communicable disease risk factors survey. Prev Med Rep. 2022; 28: 101854.
[28] American Diabetes Association. 4. Lifestyle Management: Standards of Medical Care in Diabetes-2018. Diabetes Care. 2018; 41 Suppl 1: S38–50.
[29] American Diabetes Association. 5. Prevention or Delay of Type 2 Diabetes: Standards of Medical Care in Diabetes-2018. Diabetes Care. 2018; 41 Suppl 1: S51–4.
[30] Huo D, Tao L, Li X, Wang W, Wang Z, Chen D, et al. Association of blood pressure with development of metabolic syndrome components: a five-year Retrospective Cohort study in Beijing. BMC Public Health. 2013; 13: 912.
[31] Pradhan AD. Sex differences in the metabolic syndrome: implications for cardiovascular health in women. Clin Chem. 2014; 60: 44–52.
[32] Marbou WJT, Kuete V. Prevalence of Metabolic Syndrome and Its Components in Bamboutos Division’s Adults, West Region of Cameroon. BioMed Res Int. 2019; 2019: 9676984.
[33] Zhu WH, Chen LY, Lu CR, Su L, Fang LZ. [Association between the accumulation of metabolic syndrome abnormal components and arterial pulse wave velocity among adult individuals undergoing routine health examination]. Zhonghua Xin Xue Guan Bing Za Zhi. 2018; 46: 810–7.
[34] Chen L, Zhu W, Mai L, Fang L, Ying K. The association of metabolic syndrome and its components with brachial-ankle pulse wave velocity in south China. Atherosclerosis. 2015; 240: 345–50.
[35] Wildman RP, McGinn AP, Lin J, Wang D, Muntner P, Cohen HW, et al. Cardiovascular disease risk of abdominal obesity vs. metabolic abnormalities. Obes Silver Spring Md. 2011; 19: 853–60.
[36] Tanaka A, Takeuchi K, Furuta M, Takeshita T, Suma S, Shinagawa T, et al. Relationship of toothbrushing to metabolic syndrome in middle-aged adults. J Clin Periodontol. 2018; 45: 538–47.
[37] Viitasalo A, Pitkänen N, Pahkala K, Lehtimäki T, Viikari JSA, Raitakari O, et al. Increase in adiposity from childhood to adulthood predicts a metabolically obese phenotype in normal-weight adults. Int J Obes 2005. 2020; 44: 848–51.
[38] Viitasalo A, Pahkala K, Lehtimäki T, Viikari J, Tammelin TH, Raitakari O, et al. Changes in BMI and physical activity from youth to adulthood distinguish normal-weight, metabolically obese adults from those who remain healthy. Front Endocrinol. 2022; 13: 923327.
[39] Guerrero-Romero F, Simental-Mendía LE. Hyperuricemia is Associated with the Presence of Metabolically Obese Normal-Weight and Metabolically Healthy Obese Phenotypes. Endocr Res. 2022; 47: 124–9.
[40] Morales-Gurrola G, Simental-Mendía LE, Castellanos-Juárez FX, Salas-Pacheco JM, Guerrero-Romero F. The triglycerides and glucose index is associated with cardiovascular risk factors in metabolically obese normal-weight subjects. J Endocrinol Invest. 2020; 43: 995–1000.
Cite This Article
  • APA Style

    Jeoffray Diendere, Cheick Oumar Yaro, Touwensida Eliezer Evans Kiemtore, Jean Baptiste Kiwallo, Nawidimbasba Augustin Zeba. (2023). Metabolic Disorders and Metabolically Obese Normal-Weight in Burkinabe Adults: Increasing Prevalences Across Normal BMI Quartiles, Using the 2013 STEPS Database. Central African Journal of Public Health, 9(2), 49-56. https://doi.org/10.11648/j.cajph.20230902.12

    Copy | Download

    ACS Style

    Jeoffray Diendere; Cheick Oumar Yaro; Touwensida Eliezer Evans Kiemtore; Jean Baptiste Kiwallo; Nawidimbasba Augustin Zeba. Metabolic Disorders and Metabolically Obese Normal-Weight in Burkinabe Adults: Increasing Prevalences Across Normal BMI Quartiles, Using the 2013 STEPS Database. Cent. Afr. J. Public Health 2023, 9(2), 49-56. doi: 10.11648/j.cajph.20230902.12

    Copy | Download

    AMA Style

    Jeoffray Diendere, Cheick Oumar Yaro, Touwensida Eliezer Evans Kiemtore, Jean Baptiste Kiwallo, Nawidimbasba Augustin Zeba. Metabolic Disorders and Metabolically Obese Normal-Weight in Burkinabe Adults: Increasing Prevalences Across Normal BMI Quartiles, Using the 2013 STEPS Database. Cent Afr J Public Health. 2023;9(2):49-56. doi: 10.11648/j.cajph.20230902.12

    Copy | Download

  • @article{10.11648/j.cajph.20230902.12,
      author = {Jeoffray Diendere and Cheick Oumar Yaro and Touwensida Eliezer Evans Kiemtore and Jean Baptiste Kiwallo and Nawidimbasba Augustin Zeba},
      title = {Metabolic Disorders and Metabolically Obese Normal-Weight in Burkinabe Adults: Increasing Prevalences Across Normal BMI Quartiles, Using the 2013 STEPS Database},
      journal = {Central African Journal of Public Health},
      volume = {9},
      number = {2},
      pages = {49-56},
      doi = {10.11648/j.cajph.20230902.12},
      url = {https://doi.org/10.11648/j.cajph.20230902.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20230902.12},
      abstract = {Background: Majority of Burkinabè adults were normal-weight by body mass index (BMI). This study explored by gender, the metabolic abnormalities and “metabolic obesity with body weight” (MONW) throughout the normal BMI quartiles (Q) of Burkinabè adults. Methods: We performed a secondary-analysis of data from the first WHO Stepwise approach to surveillance survey conducted in 2013 in Burkina Faso, and only adults with BMI between 18.5 – 24.9 kg/m² were included. Metabolic disorders (individual abnormal metabolic syndrome component, having at least two abnormalities and MONW) were described in BMI’ quartiles, for each gender, and the risk of occurrence of having at least two abnormalities or MONW was analysed using quartiles as dependent variables, after adjustment on sociodemographic and lifestyle factors. Results: In the 3112 adults with normal BMI and despite their gender, low high-density lipoprotein cholesterol was widespread (>75%) and its distribution did not differ across quartiles, as for raised fasting blood glucose (its prevalence was low ≈ 8%). Elevated blood pressure was the predominant abnormality in overall men (35.3%) with a significant increment starting at Q3 and reached 42.8% in Q4, while abdominal obesity was predominant in overall women (27.2%) with a significant increase starting at Q2, and reached 53.8% in Q4. In men, MONW was low (2.3%), while 30.6% had at least two abnormalities with an increasing pick starting at Q3, and prevalence was 38.0% in Q4. In women, the prevalence of MONW and those with at least two abnormalities was 8% and 39% respectively, with a common significant elevation beginning at Q3 and respectively reached 16% and 56% in Q4. Independently of sociodemographic and lifestyle factors, the number of metabolic abnormalities started to increase at Q3 in both sexes. Conclusion: Prevalence of adults with at least two metabolic abnormalities was considerable, and the number of abnormalities increased with normal BMI, and more severely in female gender in whom the prevalence of MONW was alarming. Abnormalities should also be early screened in normal-weight Burkinabè adults, more especially when their BMI reaches the Q3 cut-offs, i.e., 21.5 and 21.1 kg/m² respectively for men and women.},
     year = {2023}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Metabolic Disorders and Metabolically Obese Normal-Weight in Burkinabe Adults: Increasing Prevalences Across Normal BMI Quartiles, Using the 2013 STEPS Database
    AU  - Jeoffray Diendere
    AU  - Cheick Oumar Yaro
    AU  - Touwensida Eliezer Evans Kiemtore
    AU  - Jean Baptiste Kiwallo
    AU  - Nawidimbasba Augustin Zeba
    Y1  - 2023/03/24
    PY  - 2023
    N1  - https://doi.org/10.11648/j.cajph.20230902.12
    DO  - 10.11648/j.cajph.20230902.12
    T2  - Central African Journal of Public Health
    JF  - Central African Journal of Public Health
    JO  - Central African Journal of Public Health
    SP  - 49
    EP  - 56
    PB  - Science Publishing Group
    SN  - 2575-5781
    UR  - https://doi.org/10.11648/j.cajph.20230902.12
    AB  - Background: Majority of Burkinabè adults were normal-weight by body mass index (BMI). This study explored by gender, the metabolic abnormalities and “metabolic obesity with body weight” (MONW) throughout the normal BMI quartiles (Q) of Burkinabè adults. Methods: We performed a secondary-analysis of data from the first WHO Stepwise approach to surveillance survey conducted in 2013 in Burkina Faso, and only adults with BMI between 18.5 – 24.9 kg/m² were included. Metabolic disorders (individual abnormal metabolic syndrome component, having at least two abnormalities and MONW) were described in BMI’ quartiles, for each gender, and the risk of occurrence of having at least two abnormalities or MONW was analysed using quartiles as dependent variables, after adjustment on sociodemographic and lifestyle factors. Results: In the 3112 adults with normal BMI and despite their gender, low high-density lipoprotein cholesterol was widespread (>75%) and its distribution did not differ across quartiles, as for raised fasting blood glucose (its prevalence was low ≈ 8%). Elevated blood pressure was the predominant abnormality in overall men (35.3%) with a significant increment starting at Q3 and reached 42.8% in Q4, while abdominal obesity was predominant in overall women (27.2%) with a significant increase starting at Q2, and reached 53.8% in Q4. In men, MONW was low (2.3%), while 30.6% had at least two abnormalities with an increasing pick starting at Q3, and prevalence was 38.0% in Q4. In women, the prevalence of MONW and those with at least two abnormalities was 8% and 39% respectively, with a common significant elevation beginning at Q3 and respectively reached 16% and 56% in Q4. Independently of sociodemographic and lifestyle factors, the number of metabolic abnormalities started to increase at Q3 in both sexes. Conclusion: Prevalence of adults with at least two metabolic abnormalities was considerable, and the number of abnormalities increased with normal BMI, and more severely in female gender in whom the prevalence of MONW was alarming. Abnormalities should also be early screened in normal-weight Burkinabè adults, more especially when their BMI reaches the Q3 cut-offs, i.e., 21.5 and 21.1 kg/m² respectively for men and women.
    VL  - 9
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Unit of Nutrition, Research Institute for Health Sciences (IRSS), Bobo-Dioulasso, Burkina Faso

  • Faculty of Medicine, Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso

  • Faculty of Medicine, Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso

  • Ministry of Health and Public Hygiene, Ouagadougou, Burkina Faso

  • Unit of Nutrition, Research Institute for Health Sciences (IRSS), Bobo-Dioulasso, Burkina Faso

  • Sections