Application of the AACE/ACE advanced framework for the diagnosis of obesity and cardiometabolic disease staging in a general population from three regions of Venezuela: the vemsols study results.

Abstract

Objective: To determine the prevalence of obesity according to the AACE/ACE framework based on a complications-centric model with further application of the Cardiometabolic Disease Staging (CMDS) system in Venezuelan population. Methods: 1,320 adults were randomly selected from 3 regions. AACE/ACE framework definitions: 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 one or more mild-to-moderate ORC; and stage 2: BMI ≥ 25 and one or more severe ORC. CMDS definitions: stage 0: no metabolic syndrome (MS) components; stage 1: 1- 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 or cardiovascular disease. Results: Mean age was 44.8±0.4 years and 68.5% were females. The prevalence of obesity according to the AACE/ACE framework was 63.5%: overweight 3.0% (95% 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 of the subjects with 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 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.