Predictors of visceral obesity among patients with pathology of the gastrointestinal tract

Abstract

Background. In Ukraine, metabolic syndrome remains one of the most important problems of family medicine, it contributes to an increase in the prevalence of digestive diseases. Among the components of metabolic syndrome, researchers consider visceral obesity to be the most prognostically unfavo­rable. The purpose is to optimize diagnostic approaches to the formation of a risk group for the detection of visceral obesity in gastroenterology patients. Materials and methods. Eighty patients with gastrointestinal diseases were examined, 56 men (70.0 %) and 24 women (30.0 %). The age of the patients ranged from 18 to 66 years, with an average of (39.04 ± 1.03) years. TANITA MC-780MA body composition analyzer scales (Japan) were used to assess body structure. In all patients, serum levels of glucose, insulin, leptin, total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) were determined, as well as low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), atherogenicity coefficient (AC) and homeostasis model assessment of insulin resistance (HOMA-IR). Results. Gastroenterological patients with visce­ral obesity had more pronounced changes in lipid and carbohydrate metabolism, which were characterized by a decrease in the content of HDL-C by 16.3 % (p < 0.05), an increase in TG by 41.9 % (p < 0.001), VLDL-C by 41.7 % (p < 0.01), AС by 41.6 % (p < 0.01), HOMA-IR by 28.0 % (p < 0.01) compared to patients without visceral obesity. According to the results of the correlation analysis, functional relationships were found between the amount of visceral fat and the level of leptin (r = 0.37; р = 0.0008), insulin (r = 0.41; р = 0.001), HOMA-IR (r = 0.48; р = 0.00001), TG (r = 0.452; р = 0.017), LDL-C (r = 0.383; р = 0.016), AС (r = 0.566; p < 0.001), TG/glucose ratio (r = 0.27; p = 0.0181), HDL-C (r = –0.448; p = 0.004). Determined predictors for the development of visceral obesity were as follows: triglycerides/high-density lipoprotein ratio (odds ratio (OR) 1.32; p = 0.0001), triglycerides/glucose ratio (OR 1.17; p = 0.0014), HOMA-IR (OR 1.26; p = 0.0013), atherogenicity coefficient (OR 1.13; p = 0.0001), leptin/triglycerides ratio (OR 1.35; p = 0.0014). Conclusions. The formation of a risk group for the detection of visceral obesity with the help of defined diagnostic criteria will allow to personalize the management of gastroenterology patients already at the primary level of medical care.