Obesity is Associated with Increased Cardiovascular Risk and Increased Prevalence of Insulin Resistance among Apparently Healthy Young Adults
DOI:
https://doi.org/10.35516/jjps.v18i3.2498Keywords:
Obesity, young adults, cardiovascular risk, insulin resistanceAbstract
Objective: Cardiometabolic abnormalities are still prevalent in young individuals. This research aims to investigate associations between obesity, cardiometabolic risk factors, and insulin resistance (IR) in apparently healthy young adults.
Methods: This cross-sectional study involved 70 obese and 70 age/gender matched young adults with normal body weight. Serum glucose, insulin, lipids, and homocysteine were measured. IR was determined using Homeostasis Model Assessment-IR (HOMA-IR). Systolic (SBP) and diastolic (DBP) blood pressures were measured. Other data were self-reported.
Results: Obese participants exhibited higher SBP, DBP, glucose, triglycerides (TGs), cholesterol, low-density lipoprotein (LDL), insulin, and HOMA-IR, and lower high-density lipoprotein (HDL) compared to healthy weight participants (p-values<0.01). Body mass index (BMI) was correlated with SBP, DBP, glucose, insulin, HOMA-IR, cholesterol, LDL, TGs, and was inversely correlated with HDL (p-values<0.01). HOMA-IR was correlated with SBP, DBP, cholesterol, LDL, and TGs, and was inversely correlated with HDL (p-values<0.01). Participants with IR had higher BMI, SBP, DBP, cholesterol, LDL, and TGs compared to participants with normal insulin sensitivity (p-values<0.05). Obesity was associated with increased SBP, TGs, insulin and HOMA-IR (p-values<0.05). There was no significant difference in homocysteine between groups (p-value>0.05).
Conclusion: Obesity is associated with increased cardiovascular risk and increased prevalence of IR in apparently healthy young adults. Pharmacological and behavioral interventions are urgently needed to manage increased cardiovascular risks among this age group.
References
Fruh S.M. Obesity: Risk factors, complications, and strategies for sustainable long-term weight management. J. Am. Assoc. Nurse Pract. 2017; 29:S3-S14. DOI: https://doi.org/10.1002/2327-6924.12510
Alsulami S., et al. Obesity prevalence, physical activity, and dietary practices among adults in Saudi Arabia. Front. Public Health. 2023; 11:1124051. DOI: https://doi.org/10.3389/fpubh.2023.1124051
Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet. 2016; 387:1377-1396. DOI: https://doi.org/10.1016/S0140-6736(16)30054-X
Bustami M., et al. The prevalence of overweight and obesity among women in Jordan: A risk factor for developing chronic diseases. J. Multidiscip. Healthc. 2021; 14:1533-1541. DOI: https://doi.org/10.2147/JMDH.S313172
Finkelstein E.A., Ruhm C.J., Kosa K.M. Economic causes and consequences of obesity. Annu. Rev. Public Health. 2005; 26:239-257. DOI: https://doi.org/10.1146/annurev.publhealth.26.021304.144628
Cercato C., Fonseca F.A. Cardiovascular risk and obesity. Diabetol. Metab. Syndr. 2019; 11:74. DOI: https://doi.org/10.1186/s13098-019-0468-0
Koliaki C., Liatis S., Kokkinos A. Obesity and cardiovascular disease: Revisiting an old relationship. Metabolism. 2019; 92:98-107. DOI: https://doi.org/10.1016/j.metabol.2018.10.011
Schwartz M.W., et al. Obesity pathogenesis: An endocrine society scientific statement. Endocr. Rev. 2017; 38:267-296. DOI: https://doi.org/10.1210/er.2017-00111
Avgerinos K.I., et al. Obesity and cancer risk: Emerging biological mechanisms and perspectives. Metabolism. 2019; 92:121-135. DOI: https://doi.org/10.1016/j.metabol.2018.11.001
Abdelaal M., le Roux C.W., Docherty N.G. Morbidity and mortality associated with obesity. Ann. Transl. Med. 2017; 5:161. DOI: https://doi.org/10.21037/atm.2017.03.107
Esfahani S.B., Pal S. Obesity, mental health, and sexual dysfunction: A critical review. Health Psychol. Open. 2018; 5:2055102918786867. DOI: https://doi.org/10.1177/2055102918786867
McPhail S.M., Schippers M., Marshall A.L. Age, physical inactivity, obesity, health conditions, and health-related quality of life among patients receiving conservative management for musculoskeletal disorders. Clin. Interv. Aging. 2014; 9:1069-1080. DOI: https://doi.org/10.2147/CIA.S61732
Haider Khan H., et al. Evaluation of health-related quality of life in patients with type 2 diabetes mellitus through EQ-5D-3L: In public sector hospitals of Quetta, Pakistan. Jordan J. Pharm. Sci. 2025; 18:410-422. DOI: https://doi.org/10.35516/jjps.v18i2.2614
Wambua P.M., et al. A retrospective study on the adoption of lipid management guidelines in post-myocardial infarction patients in a tertiary care centre. Cureus. 2023; 15:e41402. DOI: https://doi.org/10.7759/cureus.41402
Powell-Wiley T.M., et al. Obesity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2021; 143:e984-e1010.
Carbone S., et al. Obesity paradox in cardiovascular disease: Where do we stand? Vasc. Health Risk Manag. 2019; 15:89-100. DOI: https://doi.org/10.2147/VHRM.S168946
Kasabri V. Plasma carnitine, choline, γ-butyrobetaine, and trimethylamine N-oxide, but not zonulin, are reduced in overweight/obese patients with pre/diabetes or impaired glycemia. Jordan J. Pharm. Sci. 2023; 16:463. DOI: https://doi.org/10.35516/jjps.v16i2.1503
Zahraa Al-Khafaje V.K., Akour A., Naffa R. Cross-sectional correlates of increasing vaspin and asymmetrical dimethylarginine plasma levels with adiposity indices and atherogenic index of plasma in metabolic syndrome subjects in Jordan. Jordan J. Pharm. Sci. 2019; 12:1.
Gruzdeva O., et al. Localization of fat depots and cardiovascular risk. Lipids Health Dis. 2018; 17:218.. DOI: https://doi.org/10.1186/s12944-018-0856-8
Yusuf S., et al. Modifiable risk factors, cardiovascular disease, and mortality in 155,722 individuals from 21 high-income, middle-income, and low-income countries (PURE): A prospective cohort study. Lancet. 2020; 395:795-808. DOI: https://doi.org/10.1016/S0140-6736(19)32008-2
Ganguly P. and Alam S.F. Role of homocysteine in the development of cardiovascular disease. Nutr J. 2015; 14:6. DOI: https://doi.org/10.1186/1475-2891-14-6
Budreviciute A., et al. Management and prevention strategies for non-communicable diseases (NCDs) and their risk factors. Front Public Health. 2020; 8:574111. DOI: https://doi.org/10.3389/fpubh.2020.574111
Shetty N.S., et al. AHA Life's essential 8 and ideal cardiovascular health among young adults. Am J Prev Cardiol. 2023; 13:100452. DOI: https://doi.org/10.1016/j.ajpc.2022.100452
Mishra S., et al. Obesity in dyslipidemia and hypertension: A study among young adults of Delhi/NCR. Clin Epidemiol Glob Health. 2023; 22:101335. DOI: https://doi.org/10.1016/j.cegh.2023.101335
Ondimu D.O., Kikuvi G.M. and Otieno W.N. Risk factors for hypertension among young adults (18–35 years) attending Tenwek Mission Hospital, Bomet County, Kenya in 2018. Pan Afr Med J. 2019; 33:210. DOI: https://doi.org/10.11604/pamj.2019.33.210.18407
Dikaiou P., et al. Obesity, overweight and risk for cardiovascular disease and mortality in young women. Eur J Prev Cardiol. 2021; 28:1351-1359. DOI: https://doi.org/10.1177/2047487320908983
Ruiz L.D., et al. Adolescent obesity: Diet quality, psychosocial health, and cardiometabolic risk factors. Nutrients. 2019; 12:1. DOI: https://doi.org/10.3390/nu12010043
Lonnie M. and Wadolowska L. Empirically derived dietary-lifestyle patterns and cardiometabolic health in young men: A review. Proc Nutr Soc. 2020; 79:324-330. DOI: https://doi.org/10.1017/S002966512000693X
Ormazabal V., et al. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018; 17:1. DOI: https://doi.org/10.1186/s12933-018-0762-4
Hill M.A., et al. Insulin resistance, cardiovascular stiffening and cardiovascular disease. Metabolism. 2021; 119:154766. DOI: https://doi.org/10.1016/j.metabol.2021.154766
Kosmas C.E., et al. Insulin resistance and cardiovascular disease. J Int Med Res. 2023; 51:3000605231164548. DOI: https://doi.org/10.1177/03000605231164548
Yang B., et al. Prevalence of hyperhomocysteinemia in China: A systematic review and meta-analysis. Nutrients. 2014; 7:74-90. DOI: https://doi.org/10.3390/nu7010074
Yang Y., et al. Prevalence and risk factors for hyperhomocysteinemia: A population-based cross-sectional study from Hunan, China. BMJ Open. 2021; 11:e048575. DOI: https://doi.org/10.1136/bmjopen-2020-048575
Apovian C.M. Obesity: definition, comorbidities, causes, and burden. Am J Manag Care. 2016; 22(Suppl 7):s176-s185.
Friedewald W.T., Levy R.I. and Fredrickson D.S. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18:499-502. DOI: https://doi.org/10.1093/clinchem/18.6.499
Matthews D.R., et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28:412-419. DOI: https://doi.org/10.1007/BF00280883
Vladu I.M., et al. Insulin resistance quantified by the value of HOMA-IR and cardiovascular risk in patients with type 2 diabetes. Exp Ther Med. 2022; 23:73. DOI: https://doi.org/10.3892/etm.2021.10996







