TY - JOUR
T1 - Adiposity Phenotypes and Subclinical Atherosclerosis in Adults from Sub-Saharan Africa
T2 - An H3Africa AWI-Gen Study
AU - Nonterah, Engelbert A
AU - Bots, Michiel L
AU - Oduro, Abraham
AU - Agongo, Godfred
AU - Soo, Cassandra C
AU - Micklesfield, Lisa K
AU - Mashinya, Felistas
AU - Boua, Palwendé R
AU - Mohamed, Shukri F
AU - Wade, Alisha N
AU - Kyobutungi, Catherine
AU - Tinto, Halidou
AU - Norris, Shane A
AU - Tollman, Stephen M
AU - Ramsay, Michèle
AU - Grobbee, Diederick E
AU - Klipstein-Grobusch, Kerstin
AU - Crowther, Nigel J
N1 - Funding Information:
The AWI-Gen Collaborative Centre is funded by the National Human Genome Research Institute (NHGRI), Office of the Director (OD), Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD), the National Institute of Environmental Health Sciences (NIEHS), the Office of AIDS research (OAR) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), of the National Institutes of Health (NIH) under award number U54HG006938 and its supplements, as part of the H3Africa Consortium. Additional funding was leveraged from the Department of Science and Technology, South Africa (SA DST), award number DST/CON 0056/2014. EAN is supported by a grant from the Global Health PhD Support Program of the University Medical Center Utrecht (UMCU), Utrecht University, The Netherlands and the Navrongo Health Research Centre (NHRC), Ghana. This paper describes the views of the authors and does not necessarily represent the official views of the National Institutes of Health (USA) or the SA DST.
Publisher Copyright:
© 2020 The Author(s).
PY - 2021/3/19
Y1 - 2021/3/19
N2 - Background: Obesity and adipose tissue distribution contribute to an increased risk of cardiovascular disease (CVD) by promoting atherosclerosis. This association has been poorly studied in sub-Saharan Africa (SSA) despite the rising prevalence of cardiovascular disease. Objectives: We determined the association between various adiposity phenotypes and carotid intima-media thickness (CIMT), a proxy of subclinical atherosclerosis, in a large SSA population. Methods: A population-based cross-sectional study was performed from 2013-2016 in Burkina Faso, Ghana, Kenya and South Africa. Body mass index (BMI), waist (WC), hip circumferences (HC), visceral (VAT) and subcutaneous adipose tissue (SCAT) using B-mode ultrasound were measured. Ultrasonography of left and right far wall CIMT of the common carotid artery was used as an indicator of subclinical atherosclerosis. Individual participant data meta-analyses were used to determine the associations between adiposity phenotypes and CIMT in the pooled sample while adjusted multivariable linear regression analyses were used for site specific analyses. Results: Data were obtained from 9, 010 adults (50.3% women and a mean age of 50± 6years). Men had higher levels of visceral fat than women while women had higher BMI, waist and hip circumference and subcutaneous fat than men at all sites except Burkina Faso. In the pooled analyses, BMI (β-value [95% CIs]: 19.5 [16.8, 22.3] μm) showed the strongest relationship with CIMT followed by VAT (5.86 [4.65, 7.07] μm), SCAT (5.00 [2.85, 7.15] μm), WC (1.27 [1.09, 1.44] μm) and HC (1.23 [1.04, 1.42] μm). Stronger associations were observed in men than in women. Conclusion: Obesity within SSA will likely result in higher levels of atherosclerosis and promote the occurrence of cardio- and cerebrovascular events, especially in males, unless addressed through primary prevention of obesity in both rural and urban communities across Africa. The inverse association of VAT with CIMT in Burkina Faso and Ghana requires further investigation.
AB - Background: Obesity and adipose tissue distribution contribute to an increased risk of cardiovascular disease (CVD) by promoting atherosclerosis. This association has been poorly studied in sub-Saharan Africa (SSA) despite the rising prevalence of cardiovascular disease. Objectives: We determined the association between various adiposity phenotypes and carotid intima-media thickness (CIMT), a proxy of subclinical atherosclerosis, in a large SSA population. Methods: A population-based cross-sectional study was performed from 2013-2016 in Burkina Faso, Ghana, Kenya and South Africa. Body mass index (BMI), waist (WC), hip circumferences (HC), visceral (VAT) and subcutaneous adipose tissue (SCAT) using B-mode ultrasound were measured. Ultrasonography of left and right far wall CIMT of the common carotid artery was used as an indicator of subclinical atherosclerosis. Individual participant data meta-analyses were used to determine the associations between adiposity phenotypes and CIMT in the pooled sample while adjusted multivariable linear regression analyses were used for site specific analyses. Results: Data were obtained from 9, 010 adults (50.3% women and a mean age of 50± 6years). Men had higher levels of visceral fat than women while women had higher BMI, waist and hip circumference and subcutaneous fat than men at all sites except Burkina Faso. In the pooled analyses, BMI (β-value [95% CIs]: 19.5 [16.8, 22.3] μm) showed the strongest relationship with CIMT followed by VAT (5.86 [4.65, 7.07] μm), SCAT (5.00 [2.85, 7.15] μm), WC (1.27 [1.09, 1.44] μm) and HC (1.23 [1.04, 1.42] μm). Stronger associations were observed in men than in women. Conclusion: Obesity within SSA will likely result in higher levels of atherosclerosis and promote the occurrence of cardio- and cerebrovascular events, especially in males, unless addressed through primary prevention of obesity in both rural and urban communities across Africa. The inverse association of VAT with CIMT in Burkina Faso and Ghana requires further investigation.
KW - Adiposity
KW - Cardiovascular disease
KW - Carotid intima-media thickness
KW - Obesity
KW - Sub-Saharan Africa
KW - Subclinical atherosclerosis
UR - http://www.scopus.com/inward/record.url?scp=85104163965&partnerID=8YFLogxK
U2 - 10.5334/GH.863
DO - 10.5334/GH.863
M3 - Article
C2 - 33833943
SN - 2211-8160
VL - 16
SP - 1
EP - 15
JO - Global Heart
JF - Global Heart
IS - 1
ER -