Vol 39 # 2 June 2007 - Kma.org.kw

June 2007KUWAIT MEDICAL JOURNAL 163increased risk of heart disease, as well as elevatedc h o l e s t e rol levels, blood pre s s u re and triglycerides [ 7 ] .Epidemiologic studies have identified severale n v i ronmental factors that contribute to thecontinued weight gain. The foremost among thesea re increasingly sedentary lifestyle and theavailability of energy-dense (high fat content), lowfiberfoods. Additional societal trends that arethought to have contributed included smoking andeating away from home particularly fast-foodwhich is typically caloric-dense [2] .Obesity is major health problem in Kuwait,more than half of adult females and almost onethird of adult males are obese [8] . The importance ofdetection and management of obesity to reduce therisk of correlated complications especially CVDprompted us to initiate this study to assess theassociation between obesity and card i o v a s c u l a rrisk factors among adult Kuwaiti nationals.SUBJECTS AND METHODSA c ross-sectional study was carried out onindividuals attending the Quortuba and AbdullaAl-Salem Primary Health Care Centers for routineexamination. The inclusion criteria were individualsnot suffering from or ever diagnosed with anyc h ronic disease such as diabetes, hypertension,heart problems or dyslipidemia. All the subjectswere adult Kuwaiti nationals aged between 20 - 44years. Pregnant women were excluded. Ac o n v e n i e n c esample of 296 subjects was chosen for this study.After a verbal consent from each individual tobe included in the study, a relevant history, physicalexamination and laboratory investigations wereperformed as part of routine check up.Data collected included personal data such asage, gender and lifestyle risk factors like currentsmoking status and level of regular aero b i cphysical activity (such as brisk walking at least 30minutes per day, most days of the week accordingto the recommendation of lifestyle modification,Seventh report of the Joint National Committee onPrevention, Detection, Evaluation and Treatment ofHigh blood Pressure) [5] . Blood pressure (BP) wasmeasured and divided to four categories accordingto the same Committee [5] as follows: Category I(normal) was those whose systolic blood pressure(SBP) was < 120 mmHg and diastolic bloodpressure (DBP) was < 80 mmHg. Category II (prehypertensivestage) was subjects with SBP between120-139 mmHg and/or DBP 80-89 mmHg. CategoryIII (stage I hypertension) were those with SBPbetween 140-159 mmHg and/or DBP 90-99 mmHg.Category IV (stage II hypertension) were individualswith SBP > 160 mmHg and/or DBP > 100 mmHg.Subjects’ weight and height were measure dusing the Detecto-Scale. Calibration was doneevery morning before use. BMI was calculated.Subjects with BMI equal or greater than 30.0 kg/m2were classified as obese, and those with BMI lessthan 30.0 kg/m 2 were considered as non-obese [4,9,10] .Blood samples were collected in the laboratoryfollowing the usual pro c e d u res. Fasting bloodsugar (FBS) (after 6-8 hours of fasting) and lipidsprofile (after 12-14 hours of fasting) were measured.FBS was classified according to the WHOcriteria [8] as normal ( 4.1 mmol/l). Also HDL was classified intodesirable (> 1.55 mmol/l), borderline (0.90 - < 1.55mmol/l) and high risk (< 0.90 mmol/l). Finally TGlevels were classified into desirable (< 4.0 mmol/l),borderline (4.0 - < 5.2 mmol/l) and high risk (> 5.2mmol/l).Data were analyzed using the StatisticalPackage for Social Sciences (SPSS), version 13.Student t-test, Chi-square test and binary logisticre g ression test were used to examine theassociation between obesity and diff e re n tcardiovascular risk factors at level of significance ofp < 0.05, and 95% confidence interval (CI).RESULTSThe study was conducted among 296 Kuwaitiadults; most of them were males (60.1%). The meanage of non-obese individuals (29.5 ± 6 years) wassignificantly lower (p < 0.05) than that of obesesubjects (31.2 ± 6.5 years). Obesity was detectedamong 124 subjects (41.9%); male genderdominated both groups of obese (59.7%) and nonobese(60.5%) individuals with no significantsignificant difference. Smoking was almost equallydistributed in both groups (37% for each). Inaddition, about one third of the obese and nonobesesubjects (33.7% and 35.5% respectively) werepracticing exercise on a regular basis with nosignificant difference.Table 1 shows the bi-variate analysis of differentrisk factors associated with obesity. Almost all therisk factors were significantly more pre v a l e n tamong the obese subjects than the non-obese. The