Sociodemographic and metabolic risk characteristics associated with metabolic weight categories in the Women's Health Initiative

Amber R Cordola Hsu; Susan L Ames; Bin Xie; Darleen V Peterson; Lorena Garcia; Scott B Going; Nathan D Wong; Hoda Anton-Culver

doi:10.1097/XCE.0000000000000194

Sociodemographic and metabolic risk characteristics associated with metabolic weight categories in the Women's Health Initiative

Cardiovasc Endocrinol Metab. 2020 May 15;9(2):42-48. doi: 10.1097/XCE.0000000000000194. eCollection 2020 Jun.

Authors

Amber R Cordola Hsu^{1

2}, Susan L Ames¹, Bin Xie¹, Darleen V Peterson¹, Lorena Garcia³, Scott B Going⁴, Nathan D Wong², Hoda Anton-Culver⁵

Affiliations

¹ School of Community and Global Health, Claremont Graduate University, The Claremont Colleges, Claremont.
² Heart Disease Prevention Program, Division of Cardiology, Department of Medicine, UC Irvine School of Medicine, University of California, Irvine, Irvine.
³ Department of Public Health Sciences, Division of Epidemiology, UC Davis School of Medicine, Davis, California.
⁴ Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, Arizona.
⁵ Department of Medicine, UC Irvine School of Medicine, University of California, Irvine, Irvine, California, USA.

Abstract

To identify sociodemographic and metabolic correlates of weight categories in postmenopausal women.

Methods: The Women's Health Initiative enrolled 161 808 postmenopausal women ages 50-79. We included those free of cardiovascular disease (CVD) and with CVD risk factors and biomarkers (n = 19 412). Normal weight was defined as a BMI ≥18.5 and <25 kg/m² and waist circumference <88 cm and overweight/obesity as a BMI ≥25 kg/m² or waist circumference ≥88 cm. Metabolically healthy was based on <2 and metabolically unhealthy ≥2 traits: triglycerides ≥150 mg/dl, systolic blood pressure (BP) ≥130 mmHg or diastolic BP ≥85 mmHg or antihypertensives or diuretics, fasting glucose ≥100 mg/dl or diabetes medication, and high-density lipoprotein cholesterol <50 mg/dl. Polytomous multinomial logistic regression with generalized link logit function provided the odds of metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUHNW), metabolically healthy overweight/obese (MHO), and metabolically unhealthy overweight/obese (MUHO) according to demographic and risk factor measures.

Results: Among the 19 412 postmenopausal women, 2369 (12.2%) participants had prevalent diabetes. Advanced age was associated with an increased odds of MUHNW as compared with the MHNW after adjusting for covariates [odds ratio (OR) 1.04, P < 0.0001]. Black/African American ethnicity was associated with a decreased odds of MUHNW (OR 0.64, P < 0.0001) and MUHO (OR 0.77, P = 0.0004), while an increased odds for MHO (OR 1.50, P < 0.0001) as compared with White MHNW.

Conclusions: Advanced age and ethnicity are important indicators of metabolic weight categories among postmenopausal women.

Keywords: Women’s Health Initiative; cardiometabolic disease; diabetes; obesity; postmenopausal women.