Conceptual positioning for the obesity phenotypes identification at the beginning of pregnancy
Keywords:
adiposity, pregnancy, phenotypes, body mass index, obesity, metabolic syndrome.Abstract
The obesity phenotypes settle down in individuals with equal body mass index that present different metabolic profiles and health prognosis. Its presence from early stages of life increases the probability that women get pregnant with this characteristic, so it is considered necessary to promote a conceptual position for its identification at the beginning of pregnancy. In normal-weight pregnant woman, we propose to use the value of 30% or the 90th percentile of the sum of the triceps and subescapularis skinfold to define obese normal-weight phenotype. Of these, those with values equal to or greater than the 75th percentile of visceral adiposity index and the lipids accumulation product would be considered obese metabolically normal-weight. In obese pregnant woman the use of the criteria that define metabolic syndrome in women, is proposed to identify the metabolic health. The exposed theoretical foundations demonstrate the suitability of stratifying metabolic risk at the beginning of pregnancy by classifying it into obesity phenotypes, through anthropometric, biochemical, and clinical indicators.Downloads
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References
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6. Madeira F, Silva A, Veloso H, Goldani M, Kac G, Cardoso V. Normal weight obesity is associated with metabolic syndrome and insulin resistance in young adults from a middle-income country. PLoSOne. 2013[acceso: 31/01/2023];8(3):[aprox. 5 pant.] Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610876/pdf/pone.0060673.pdf
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8. Liu C, Wang C, Guan S, Liu H, Wu X, Zhang Z. The Prevalence of Metabolically Healthy and Unhealthy Obesity according to Different Criteria Obesity Facts. 2019 [acceso: 21/08/2022];12(1):78-90. Disponible en: https://www.karger.com/Article/FullText/495852
9. Correa-Rodríguez M, González-Ruíz K, Rincón-Pabón D, Izquierdo M, García-Hermoso A, Agostinis-Sobrinho C, et al. Normal-Weight Obesity Is Associated with Increased Cardiometabolic Risk in Young Adults. Nutrients. 2020[acceso: 21/08/2022]; 12(4):1106. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230158/pdf/nutrients-12-01106.pdf
10. April-Sanders AK, Rodriguez CJ. Metabolically Healthy Obesity Redefined. JAMA Network Open. 2021[acceso: 21/08/2022]; 4(5):e218860. Disponible en: http://dx.doi.org/10.1001/jamanetworkopen.2021.8860
11. Pluta W, Dudzinska W, Lubkowska A. Metabolic Obesity in People with Normal Body Weight (MONW)-Review of Diagnostic Criteria. Int. J. Environ. Res. Public Health. 2022[acceso: 18/03/2023]; 19(2):624. Disponible en: https://www.mdpi.com/1660-4601/19/2/624
12. Ashtary-Larky D, Niknam S, Alipour M, Bagheri R, Asbaghi O, Mohammadian M, et al. Are Women with Normal-Weight Obesity at Higher Risk for Cardiometabolic Disorders? Biomedicines. 2023[acceso: 18/03/2023]; 11(2):[aprox. 13 pant.].Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9953250/
13. Pastusiak K, Przyslawski J. The criteria of the identification of metabolic obesity among people with normal body weight and their use in everyday practice. Journal of Medical Science. 2018[acceso: 21/03/2023]; 87(1):34-9. Disponible en: https://doi.org/10.20883/jms.2018.259
14. Wang W, Wei W, Song Y, Guo H, Zhang X, Wang X, et al. Metabolically healthy obesity and unhealthy normal weight rural adults in Xinjiang: prevalence and the associated factors. BMC Public Health. 2021[acceso: 21/03/2023]; 21(1940):1-10. Disponible en: https://doi.org/10.1186/s12889-021-11996-y
15. Blüher M. Metabolically Healthy Obesity. Endocrine Reviews. 2022[acceso: 21/03/2023];41(3):1-16. Disponible en: https://academic.oup.com/edrv/article/41/3/bnaa004/5780090
16. Muñoz Gualan GG, Muñoz Gualan AP. Metabolic syndrome prevalence in military personnel and correlation with anthropometric values in Ecuador. Rev Cubana Med Milit. 2023[acceso: 17/04/2023]; 52(2):e02302401. Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/2401
17. Orozco Muñoz C, Cañizares Luna O, Sarasa Muñoz N. Estado nutricional, acumulación de tejido adiposo y vulnerabilidad cardiometabólica en gestantes sanas de peso adecuado. Gac Méd Espirit. 2018[acceso: 21/03/2023]; 20(2):40-7. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1608-89212018000200040&lng=es
18.Gaston S, Tulve N, Ferguson T. Abdominal obesity, metabolic dysfunction, and metabolic syndrome in U.S. adolescents: National Health and Nutrition Examination Survey 2011-2016. Annals of Epidemiology. 2019[acceso: 21/03/2023]; 30:30-6. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459599/
19. Hung CY, Chang CW, Chen CJ, Chang CW, Cheng HY, Chen MJ. Sonographic Measurement of Visceral Fat and Prediction of Metabolic Syndrome in the Elderly. International Journal of Gerontology. 2018[acceso: 21/03/2023]; 12(4):331-5. Disponible en: https://www.sciencedirect.com/science/article/pii/S1873959818300279
20. Cuatrecasas G, de Cabo F, Coves MJ, Patrascioiu I, Aguilar G, March S, et al. Ultrasound measures of abdominal fat layers correlate with metabolic syndrome features in patients with obesity. 2020[acceso: 21/03/2023]; 6(6):660-7. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33354344/
21. Firoozeh A, Somayeh M, Hosseini R, Amirhossein M. Ultrasound Evaluation of Visceral Fat Thickness for Prediction of Metabolic Syndrome in the First Trimester of Pregnancy in a Sample of Non-obese Iranian Women. Oman Medical Journal. 2019[acceso: 21/03/2023]; 34(4):308-12. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642717/
22. Alves JG, Souza ASR, Figueiroa JN, de Araújo CAL, Guimarães A, Ray JG. Visceral Adipose Tissue Depth in Early Pregnancy and Gestational Diabetes Mellitus a Cohort Study. Scientific Reports. 2020[acceso: 21/03/2023]; 10(1):2032. Disponible en: https://doi.org/10.1038/s41598-020-59065-5
23. Gültekin A, Özsoy G, Pinar O, Akdur G. The predictive value of 1erst trimester anthropometric and Ultrasonographic adipose tissue measurements in gestational diabetes mellitus. ObstetGynaecol. 2021[acceso: 21/12/2022]; 47(9):[aprox. 6pant.]. Disponible en: https://obgyn.onlinelibrary.wiley.com/doi/10.1111/jog.14887?af=R
24. Pétursdóttir Maack H, Sundström Poromaa I, Lindström L, Mulic-Lutvica A, Junus K, WikströmAK. Ultrasound estimated subcutaneous and visceral adipose tissue thicknesses and risk of pre-eclampsia. Scientific Reports. 2021[acceso: 21/12/2022]; 11(1):22740. Disponible en: https://doi.org/10.1038/s41598-021-02208-z
25. Tabatabaei-Malazy O, Saeedi Moghaddam S, Masinaei M. Association between being metabolically healthy/unhealthy and metabolic syndrome in Iranian adults. PLoSONE. 2022[acceso: 21/12/2022]; 17(1):e0262246. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34990491/
26. De Lorenzo A, Soldati L, Sarlo F, Calvani M, Di Lorenzo N, Di Renzo L. New obesity classification criteria as a tool for bariatric surgery indication. World J Gastroenterol. 2016[acceso: 21/12/2022]; 22(2):[aprox. 5pant.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4716069/#__ffn_sectitle
27. Tayefi M, Tayefi B, Darroudi S, Mohammadi-Bajgiran M, Mouhebati M, Heidari-Bakavoli A, et al. There is an association between body fat percentage and metabolic abnormality in normal weight subjects: Iranian large population. Translational Metabolic Syndrome Research. 2019[acceso: 21/12/2022]; 2(1):11-6. Disponible en: https://www.sciencedirect.com/science/article/pii/S2588930319300015
28. Chen Q, Zhou Y, Dai C, Zhao G, Zhu Y, Zhang X. Metabolically Abnormal But Normal-Weight Individuals Had a Higher Risk of Type 2 Diabetes Mellitus in a Cohort Study of a Chinese Population. Frontiers in Endocrinology. 2021[acceso: 21/12/2022]; 2:[aprox. 8pant.].Disponible en: https://doi.org/10.3389/fendo.2021.724873
29. Orozco Muñoz C. Salud cardiometabólica en el postparto a corto plazo en mujeres sanas de peso adecuado al momento de la captación [Tesis Doctoral]. Villa Clara. Cuba: Universidad de Ciencias Médicas de Villa Clara; 2021. Disponible en: http://tesis.sld.cu/index.php?P=FullRecord&ID=770
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Published
2023-11-13
How to Cite
1.
Ramírez Mesa C, Sarasa Muñoz NL, Guillen Estevez AL, Suárez González JA. Conceptual positioning for the obesity phenotypes identification at the beginning of pregnancy. Rev Cubana Med Milit [Internet]. 2023 Nov. 13 [cited 2025 Feb. 26];52(4):e02303010. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/3010
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