Identification of Comprehensive Metabotypes Associated with Cardiometabolic Diseases in the Population-Based KORA Study

SCOPE

"Metabotyping" describes the grouping of metabolically similar individuals. We aimed to identify valid metabotypes in a large cohort for targeted dietary intervention, for example, for disease prevention.

METHODS AND RESULTS

We grouped 1729 adults aged 32-77 years of the German population-based KORA F4 study (2006-2008) using k-means cluster analysis based on 34 biochemical and anthropometric parameters. We identified three metabolically distinct clusters showing significantly different biochemical parameter concentrations. Cardiometabolic disease status was determined at baseline in the F4 study and at the 7 year follow-up termed FF4 (2013/2014) to compare disease prevalence and incidence between clusters. Cluster 3 showed the most unfavorable marker profile with the highest prevalence of cardiometabolic diseases. Also, disease incidence was higher in cluster 3 compared to clusters 2 and 1, respectively, for hypertension (41.2%/25.3%/18.2%), type 2 diabetes (28.3%/5.1%/2.0%), hyperuricemia/gout (10.8%/2.3%/0.7%), dyslipidemia (19.2%/18.3%/5.6%), all metabolic (54.5%/36.8%/19.7%), and all cardiovascular (6.3%/5.5%/2.3%) diseases together.

CONCLUSION

Cluster analysis based on an extensive set of biochemical and anthropometric parameters allows the identification of comprehensive metabotypes that were distinctly different in cardiometabolic disease occurrence. As a next step, targeted dietary strategies should be developed with the goal of preventing diseases, especially in cluster 3.

Metabotyping and its application in targeted nutrition: an overview

Metabolic diversity leads to differences in nutrient requirements and responses to diet and medication between individuals. Using the concept of metabotyping – that is, grouping metabolically similar individuals – tailored and more efficient recommendations may be achieved. The aim of this study was to review the current literature on metabotyping and to explore its potential for better targeted dietary intervention in subjects with and without metabolic diseases. A comprehensive literature search was performed in PubMed, Google and Google Scholar to find relevant articles on metabotyping in humans including healthy individuals, population-based samples and patients with chronic metabolic diseases. A total of thirty-four research articles on human studies were identified, which established more homogeneous subgroups of individuals using statistical methods for analysing metabolic data. Differences between studies were found with respect to the samples/populations studied, the clustering variables used, the statistical methods applied and the metabotypes defined. According to the number and type of the selected clustering variables, the definitions of metabotypes differed substantially; they ranged between general fasting metabotypes, more specific fasting parameter subgroups like plasma lipoprotein or fatty acid clusters and response groups to defined meal challenges or dietary interventions. This demonstrates that the term ‘metabotype’ has a subjective usage, calling for a formalised definition. In conclusion, this literature review shows that metabotyping can help identify subgroups of individuals responding differently to defined nutritional interventions. Targeted recommendations may be given at such metabotype group levels. Future studies should develop and validate definitions of generally valid metabotypes by exploiting the increasingly available metabolomics data sets.

Comparison of anthropometric characteristics between normotensive and hypertensive individuals among a population of Bengalee Hindu elderly men in Calcutta, India

A comparative investigation of 99 normotensive and 111 hypertensive Bengalee Hindu elderly men (aged 55 years and above) of Kalighat, South Calcutta, India, was undertaken to study differences in levels of adiposity, body fat distribution and body composition between these two groups. Results revealed that there were significant differences between normotensive (NT) and hypertensive (HT) subjects in the mean values for weight (p < 0.05), body mass index (BMI, p < 0.01); waist (p < 0.001) and hip circumferences (p < 0.05); waist-hip ratio (WHR, p < 0.001), conicity index (CI, p < 0.01) and fat free mass (FFM, p < 0.001). Percentile distributions for all these variables and indices showed consistently higher values among the HT patients as compared with NT subjects. However, the frequency of obesity (BMI > or = 25) was similar (NT = 6.1%, HT = 11.7%) in both groups. Thus, these results indicated that there existed significant differences in central adiposity and FFM between NT and HT subjects although their level of obesity was similar. Hypertensive individuals have significantly enhanced levels of central body fat distribution.

Blood pressure and adiposity: A comparative study of socioeconomically diverse groups of Andhra Pradesh, India

The effect of adiposity on blood pressures, systolic (SBP), and diastolic (DBP), was examined in a sample of 1119 individuals (456 males, 663 females), 18-75 years, from socioeconomically diverse populations from Southern Andhra Pradesh, India. The populations were graded into four socioeconomic groups, group I-seminomadic Yerukalas, group II-hard working scheduled caste Mala and the Muslims, group III-land owning agricultural castes Reddy and Balija, and group IV-sedentary urban dwelling castes such as Brahmins, Vyshyas, and Marwadis. There was a trend of increase in mean blood pressures and the frequency of hypertensives (SBP ≥160 and/or DBP ≥95) with increasing age in all groups, and the increase was more distinct from group I to group IV. Mean values of body mass index (BMI: weight/height² ) and body fat (SF4: sum of biceps, triceps, subscapular, and suprailiac skinfolds) also showed an increasing trend from group I to group IV. A somewhat opposite trend was evident in two indices of fat distribution, centripetal fat ratio (CFR: ratio of subscapular to the sum of subscapular and triceps skin fold thicknesses) and the relative fat pattern index (RFPI: ratio of subscapular skinfold thickness to the sum of subscapular and suprailiac skinfold thicknesses). Step-wise regression analysis indicated that while one or the other adiposity measures along with one of the age terms significantly contributed to SBP variation among males in the affluent groups III and IV, neither any adiposity measure nor age explain the variation in group I, and only body fat, not age, in group II. A qualitatively similar pattern was observed in females, except that BMI explained a significant amount of variation in SBP in group I, and only age and not any of the adiposity measures, in group IV. Besides age, BMI and fat pattern indices accounted for a significant amount of variation in DBP, while RFPI explained a significant amount of variation in group IV. The amount of variation in SBP explained by the age and adiposity measures increased from the traditional to urbanized groups in males (2.4% to 24.8%) and females (11.4% to 43.6%). A similar trend was observed in case of DBP in both males (0.2% to 15.4%) and females (7.6% to 21.8%). Analysis of covariance of the pooled sample suggested that each of five categorical variables-physical activity, smoking, income, food habit, and group membership-independently explained a significant amount of residual variation in SBP of males, while only food habit and social status did so in females. DBP variation, however, was significantly accounted for by only three of the five (excluding food habit and smoking) categorical variables in males and by none in females. The effect of categorical variables on the residual variation in SBP becomes increasingly significant from the traditional to the urbanized groups in males, while this trend is not consistent in females. Am. J. Hum. Biol. 10:5-21, 1998. © 1998 Wiley-Liss, Inc.

Leisure time physical activity is a significant predictor of body density in men

The purposes were to: (a) develop and cross-validate a prediction equation for body density with leisure time physical activity (LTA) serving as a potential predictor, and (b) determine whether the addition of LTA to previously published regression equations would improve their prediction. Body density (hydrostatic weighing) was measured in a validation group of 193 men (18-78 years), and was predicted by age, body mass index, subscapular skinfold, abdominal skinfold, thigh skinfold, waist circumference, and LTA. This equation cross-validated on an independent group of men (N = 96). Consequently, groups were combined (N = 289) to yield a new equation that also included the same seven variables plus the waist/thigh circumference ratio (R = 0.90, R2 = 0.81, SEE = 0.0085 g/ml, p < 0.0001). Additionally, LTA improved the prediction of published equations obtained from men of various ages. In conclusion, LTA is an independent predictor of body density in healthy men comprising a wide age range.

The association of body fat location with haemodynamic and metabolic status in men and women aged 21-60 years

The importance of body fat location as a predictor of metabolic aberrations was evaluated in 214 males and 244 females [aged 21-60] randomly selected from the patients of one general practice of Castel D'Azzano (Italy). The metabolic pattern, indexed by blood pressure, blood glucose, uric acid, serum triglycerides, HDL- and LDL-cholesterol was summarized in a haemodynamic-metabolic score (HMS). Association of HMS with age, anthropometric variables (skinfold thicknesses, girth lengths) and degree of overweight (body mass index, BMI) was evaluated in males and females using multiple regression analysis. Body fat location was associated with metabolic status independent of age in both sexes. This association was also independent of the degree of overweight. BMI, in general, was associated with HMS to a greater extent than anthropometric variables, except for waist girth; when its effect was taken into account BMI did not significantly improve the prediction power of HMS values in males. Among skinfolds, epimesogastric showed in both sexes the highest association with HMS. These results support the abdominal adiposity hypothesis and suggest that waist circumference could be a good index for assessing metabolic status. The abdominal location of adipose tissue, more than just the degree of overweight, could play a role in obesity related disorders.