José Carlos Fernández-García1,2, Araceli Muñoz-Garach1,2, Miguel Ángel Martínez-González2,3,4, Jordi Salas-Salvado2,5,6,7, Dolores Corella2,8, Álvaro Hernáez2,9,10, Dora Romaguera2,11, Jesús Vioque12,13, Ángel M Alonso-Gómez2,14,15, Julia Wärnberg2,16, J Alfredo Martínez2,17,18, Luís Serra-Majem2,19, Ramón Estruch2,9,20, José Lapetra2,21, Xavier Pintó2,20,22, Josep A Tur2,23, Antonio Garcia-Rios2,24, Laura García Molina12,25, José Juan Gaforio12,26, Pilar Matía-Martín27, Lidia Daimiel28, Vicente Martín Sánchez12,29, Josep Vidal30,31, Lucia Prieto32, Emilio Ros2,33, Nuria Goñi2,3, Nancy Babio2,5,6,7, Carolina Ortega-Azorin2,8, Olga Castañer2,34, Jadwiga Konieczna2,11, Leyre Notario Barandiaran12,13, Jessica Vaquero-Luna2,14, Juan Carlos Benavente-Marín2,16, M Angeles Zulet2,17, Almudena Sanchez-Villegas2,19, Emilio Sacanella2,9,20, Ricardo Gómez Huelgas2,35, Leticia Miró-Moriano2,21, Mariano Gimenez-Gracia2,22, Alicia Julibert2,11,23, Cristina Razquin2,3,4, Josep Basora5,7, Olga Portolés2,8, Albert Goday20,34, Aina M Galmés-Panadés2,11, Carmen M López-García36, Anai Moreno-Rodriguez2,14, Estefanía Toledo2,3,4, Andrés Díaz-López2,5,6,7, Montserrat Fitó2,34, Francisco J Tinahones1,2, M Rosa Bernal-López2,35. 1. Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Malaga University, Instituto de Investigación Biomédica de Malaga (IBIMA), Malaga, Spain. 2. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain. 3. Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain. 4. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. 5. Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Unitat de Nutrició, Reus, Spain. 6. Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain. 7. Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain. 8. Department of Preventive Medicine, University of Valencia, Valencia, Spain. 9. Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain. 10. Blanquerna, School of Health Sciences Organization, Universitat Ramon Llull, Barcelona, Spain. 11. Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain. 12. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. 13. Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain. 14. Department of Cardiology, Organización Sanitaria Integrada (OSI) ARABA, University Hospital Araba, Vitoria-Gasteiz, Spain. 15. University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain. 16. Department of Nursing, School of Health Sciences, University of Málaga-Instituto de Investigación Biomédica de Malaga (IBIMA), Málaga, Spain. 17. Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain. 18. Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. 19. Nutrition Research Group, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain. 20. University of Barcelona, Barcelona, Spain. 21. Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain. 22. Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain. 23. Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain. 24. Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain. 25. Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain. 26. Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain. 27. Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain. 28. Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. 29. Institute of Biomedicine (IBIOMED), University of León, León, Spain. 30. CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. 31. Department of Endocrinology, Institut d'Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain. 32. Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain. 33. Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain. 34. Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain. 35. Department of Internal Medicine, Regional University Hospital of Malaga, Instituto de Investigación Biomédica de Malaga (IBIMA), Malaga, Spain. 36. Centro Salud Raval de Elche, Alicante, Spain.
Abstract
OBJECTIVE: The hypertriglyceridemic waist (HTGW) phenotype is characterized by abdominal obesity and high levels of triglycerides. In a cross-sectional assessment of PREDIMED-Plus trial participants at baseline, HTGW phenotype prevalence was evaluated, associated risk factors were analyzed, and the lifestyle of individuals with metabolic syndrome and HTGW was examined. METHODS: A total of 6,874 individuals aged 55 to 75 with BMI ≥ 27 and < 40 kg/m2 were included and classified by presence (HTGW+ ) or absence (HTGW- ) of HTGW (waist circumference: men ≥ 102 cm, women ≥ 88 cm; fasting plasma triglycerides ≥ 150 mg/dL). Analytical parameters and lifestyle (energy intake and expenditure) were analyzed. RESULTS: A total of 38.2% of the sample met HTGW+ criteria. HTGW+ individuals tended to be younger, have a greater degree of obesity, be sedentary, and be tobacco users. They had higher peripheral glucose, total cholesterol, and low-density lipoprotein cholesterol levels; had lower high-density lipoprotein cholesterol levels; and had increased prevalence of type 2 diabetes mellitus. Mediterranean diet (MedDiet) adherence and physical activity were greater in HTGW- patients. Age, BMI, tobacco use, total energy expenditure, hypertension, type 2 diabetes mellitus, and MedDiet adherence were associated with HTGW+ . CONCLUSIONS: HTGW is a highly prevalent phenotype in this population associated with younger age, higher BMI, tobacco use, and decreased MedDiet adherence. HTGW- individuals were more physically active with greater total physical activity, and fewer had hypertension.
OBJECTIVE: The hypertriglyceridemic waist (HTGW) phenotype is characterized by abdominal obesity and high levels of triglycerides. In a cross-sectional assessment of PREDIMED-Plus trial participants at baseline, HTGW phenotype prevalence was evaluated, associated risk factors were analyzed, and the lifestyle of individuals with metabolic syndrome and HTGW was examined. METHODS: A total of 6,874 individuals aged 55 to 75 with BMI ≥ 27 and < 40 kg/m2 were included and classified by presence (HTGW+ ) or absence (HTGW- ) of HTGW (waist circumference: men ≥ 102 cm, women ≥ 88 cm; fasting plasma triglycerides ≥ 150 mg/dL). Analytical parameters and lifestyle (energy intake and expenditure) were analyzed. RESULTS: A total of 38.2% of the sample met HTGW+ criteria. HTGW+ individuals tended to be younger, have a greater degree of obesity, be sedentary, and be tobacco users. They had higher peripheral glucose, total cholesterol, and low-density lipoprotein cholesterol levels; had lower high-density lipoprotein cholesterol levels; and had increased prevalence of type 2 diabetes mellitus. Mediterranean diet (MedDiet) adherence and physical activity were greater in HTGW- patients. Age, BMI, tobacco use, total energy expenditure, hypertension, type 2 diabetes mellitus, and MedDiet adherence were associated with HTGW+ . CONCLUSIONS: HTGW is a highly prevalent phenotype in this population associated with younger age, higher BMI, tobacco use, and decreased MedDiet adherence. HTGW- individuals were more physically active with greater total physical activity, and fewer had hypertension.