APPLICATION OF THE AACE/ACE ADVANCED FRAMEWORK FOR THE DIAGNOSIS OF OBESITY AND CARDIOMETABOLIC DISEASE STAGING IN A GENERAL POPULATION FROM 3 REGIONS OF VENEZUELA: THE VEMSOLS STUDY RESULTS.

ABSTRACT

OBJECTIVE: To determine the prevalence of obesity according to the American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) framework based on a complications-centric model with further application of the Cardiometabolic Disease Staging (CMDS) system in a Venezuelan population. METHODS: A total of 1,320 adults were randomly selected from 3 regions. The AACE/ACE framework definitions were as follows overweight, body mass index (BMI) 25 to 29.9 kg/m2 and no obesity-related complications (ORC); obesity stage 0, BMI ≥30 and no ORC; stage 1, BMI ≥25 and 1 or more mild-to-moderate ORC; and stage 2, BMI ≥25 and 1 or more severe ORC. CMDS definitions were as follows stage 0, no metabolic syndrome (MS) components; stage 1, 1 to 2 MS components without impaired fasting glucose (IFG); stage 2, IFG or ≥3 MS components but without IFG; stage 3, IFG and MS; and stage 4, type 2 diabetes (T2D) or cardiovascular disease. RESULTS: The mean age was 44.8 ± 0.4 years, and 68.5% were female. The prevalence of obesity according to the AACE/ACE framework was 63.1% overweight 3.0% (95% confidence interval [CI] 2.1-3.9); obesity stage 0 0.1% (0.07-0.27); obesity stage 1 26.6% (24.2-29.0); and obesity stage 2 36.4% (33.8-39.0). Most subjects with a BMI <25 were CMDS 0 or 1. In those with BMI ≥ 25, only 4.6% were CMDS 0. The prevalence of obesity according to the World Health Organization (WHO, BMI ≥30) was 29.3% (24.7-33.7). CONCLUSION: In a general population study, applying the AACE/ACE framework for obesity and CMDS increased the detection of ORC and therefore higher risk subjects compared to classic anthropometric measurements. ABBREVIATIONS AACE = American Association of Clinical Endocrinologists; ACE = American College of Endocrinology; BMI = body mass index; CMDS = Cardiometabolic Disease Staging; DALY = disability-adjusted life years; LA = Latin America; MS = metabolic syndrome; ORC = obesity-related complications; WC = waist circumference; WHO = World Health Organization.