Relationships between adiposity distribution and metabolic health in preconception women in South Africa

Alessandra Prioreschi; John R Koethe; David M Aronoff; Jeffrey A Goldstein; Shane A Norris

doi:10.1002/osp4.570

Relationships between adiposity distribution and metabolic health in preconception women in South Africa

Obes Sci Pract. 2022 Jan 3;8(4):500-509. doi: 10.1002/osp4.570. eCollection 2022 Aug.

Authors

Alessandra Prioreschi¹, John R Koethe^{2

3}, David M Aronoff^{1

2

4

5}, Jeffrey A Goldstein⁶, Shane A Norris¹

Affiliations

¹ SAMRC/Wits Developmental Pathways for Health Research Unit Department of Paediatrics Faculty of Health Sciences School of Clinical Medicine University of the Witwatersrand Johannesburg South Africa.
² Division of Infectious Diseases Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA.
³ Vanderbilt Institute for Global Health Vanderbilt University Medical Center Nashville Tennessee USA.
⁴ Department of Pathology, Microbiology and Immunology Vanderbilt University Medical Center Nashville Tennessee USA.
⁵ Department of Obstetrics and Gynecology Vanderbilt University Medical Center Nashville Tennessee USA.
⁶ Department of Pathology Feinberg School of Medicine Northwestern University Chicago Illinois USA.

Abstract

Objective: Adipose tissue is a central regulator of metabolic health and a contributor to systemic inflammation. Patterns of adiposity deposition are important to understand for optimizing health. This study aimed to asses relationships between adiposity deposition and metabolic and inflammatory biomarkers in South African women prior to conception.

Methods: Non-pregnant, healthy women (n = 298) were recruited for this cross-sectional study via home visits. Body composition was measured by Dual X-ray Absorptiometry. Inflammation markers C-reactive protein (CRP), alpha1-acid glycoprotein (AGP), hemoglobin A1c (HbA1c), and blood pressure were scored according to risk. A summative metabolic health risk score was created for women with obesity. Generalized regression models assessed relationships between adiposity deposition and outcomes with adjustment for potential confounders.

Results: Obesity was present in 22% of women (mean age = 20.93 years). Fat mass index was associated with inflammation and metabolic health risk (β = 0.58; p < 0.01). Visceral fat, trunk:limb ratio, android:gynoid ratio, body mass index, weight, and waist circumference were positively associated with CRP, AGP, and metabolic health risk (p < 0.01). Weight was associated with Hba1c (β < 0.01; p < 0.05). Participants with obesity and low metabolic health risk had lower fat mass index and visceral fat than participants with obesity and higher metabolic health risk.

Conclusions: Black South African women accumulated excess adipose tissue in abdominal regions. While fat mass and body mass were associated with inflammation and metabolic health risk, women with obesity and with lower fat mass index and lower visceral adipose tissue were metabolically protected. Identification of women at risk for metabolic disease preconception could help ensure future healthy pregnancies and prevent transference of risk to offspring.

Keywords: DXA; obesity; preconception; women's health.