Relations of body habitus, fitness level and cardiovascular risk factors including Lipoproteins and Apolipoproteins in a rural and urban Costa Rican population

Abstract

Increased general and abdominal obesity has been independently associated with diabetes, increased risk of stroke, and coronary artery disease (CAD). It is more prevalent in developed countries and in urban areas of nonindustrialized nations than in less developed and rural areas. To evaluate the associations between general and abdominal obesity (as determined by total body fat, waist to hip ratio, umbilical to triceps ratio, and umbilical to subscapular ratio) with glucose, plasma lipoproteins, apolipoprotein (apo) A-I and B concentrations, and low density lipoprotein (LDL) particle size (LDL 1-7), we randomly selected 222 men and 243 women from rural and urban areas of Puriscal, Costa Rica. Abdominal obesity, as assessed by the waist to hip ratio, was independently and significantly associated with higher triglyceride levels (p <O.01) and with lower high density lipoprotein cholesterol levels (p <0.05) in men and women and with higher glucose levels ( p <0.05) and smaller LDL particle size (p <0.01) in women. Abdominal obesity, as assessed by the umbilical to subscapular ratio, was independently and significantly associated with higher total cholesterol (p <0.005) and apo B (p<0.01) levels. Umbilical to triceps ratio was positively associated with blood pressure in men. Urban men had increased general and abdominal obesity (p <0.0001), number of cigarettes smoked per day (p <0.0001), and diastolic blood pressure (p <0.05) and had a decreased fitness level (p <0.0001) as well as higher (p <0.05) plasma glucose, triglyceride, and total cholesterol concentrations and lower (p<0.05) apo A-I and IIDL cholesterol levels compared with rural men. The differences between rural and urban women were not as striking. Urban women had increased general and abdominal obesity, glucose, and apo B levels (p<0.05) and a decreased fitness level (p <0.0001). Our data indicate that general and abdominal obesity, increased cigarette smoking, diastolic blood pressure, and decreased fitness level are more prevalent in an urban than in a rural area in Costa Rica, particularly in men. The higher prevalence of such risk factors in the urban area is associated with a more atherogenic plasma lipoprotein profile.